Provider Demographics
NPI:1396713954
Name:BROWN, WILLIAM CHARLES JR (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CHARLES
Last Name:BROWN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 BAILEY DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON CROSSING
Mailing Address - State:PA
Mailing Address - Zip Code:18977-1010
Mailing Address - Country:US
Mailing Address - Phone:215-622-3771
Mailing Address - Fax:
Practice Address - Street 1:451 S STATE ST STE B
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-3566
Practice Address - Country:US
Practice Address - Phone:215-943-7800
Practice Address - Fax:215-943-7993
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2022-10-14
Deactivation Date:2022-09-08
Deactivation Code:
Reactivation Date:2022-10-13
Provider Licenses
StateLicense IDTaxonomies
PAMD025381E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD025381EOtherPA LICENCE
PA427721FMMOtherMEDICAREPA
NJ2955601Medicaid