Provider Demographics
NPI:1285836593
Name:BROWN, GREGORY OSCAR (CFSW1)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:OSCAR
Last Name:BROWN
Suffix:
Gender:M
Credentials:CFSW1
Other - Prefix:MR
Other - First Name:GREG
Other - Middle Name:OSCAR
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CFSW1
Mailing Address - Street 1:3245 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-7809
Mailing Address - Country:US
Mailing Address - Phone:907-364-4410
Mailing Address - Fax:907-364-4484
Practice Address - Street 1:3245 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-7809
Practice Address - Country:US
Practice Address - Phone:907-364-4410
Practice Address - Fax:907-364-4484
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)