Provider Demographics
NPI:1972726628
Name:BROWN, CYNTHIA CARLEEN (OD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:CARLEEN
Last Name:BROWN
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:1750 INDIANAPOLIS RD
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:46135-7448
Mailing Address - Country:US
Mailing Address - Phone:765-655-1759
Mailing Address - Fax:765-655-1278
Practice Address - Street 1:1750 INDIANAPOLIS RD
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:IN
Practice Address - Zip Code:46135-7448
Practice Address - Country:US
Practice Address - Phone:765-655-1759
Practice Address - Fax:765-655-1278
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2012-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002193152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN22438Medicare UPIN