Provider Demographics
NPI:1427011030
Name:BROWN, CARRIE M (MD)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHILDRENS WAY
Mailing Address - Street 2:SLOT 900
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-364-4363
Mailing Address - Fax:501-364-3404
Practice Address - Street 1:1 CHILDRENS WAY
Practice Address - Street 2:SLOT 900
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3500
Practice Address - Country:US
Practice Address - Phone:501-364-4363
Practice Address - Fax:501-364-3404
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-5230208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-1351UMedicaid
AR163969001Medicaid
1351UOtherBCBS
NCI21620Medicare UPIN
AR5AJ07Medicare PIN