Provider Demographics
NPI:1295620862
Name:BROWN, MITCHELL CULLEN (PA-C)
Entity type:Individual
Prefix:MR
First Name:MITCHELL
Middle Name:CULLEN
Last Name:BROWN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:75 W 18TH ST APT 448
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-1699
Mailing Address - Country:US
Mailing Address - Phone:812-568-8918
Mailing Address - Fax:
Practice Address - Street 1:7911 MICHIGAN RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1915
Practice Address - Country:US
Practice Address - Phone:317-956-6288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant