1649336249 NPI number — DR. MICHAEL D BROWN ND

Table of content: DR. MICHAEL D BROWN ND (NPI 1649336249)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649336249 NPI number — DR. MICHAEL D BROWN ND

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
MICHAEL
Provider Middle Name:
D
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
ND
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649336249
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11240 STRANG LINE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LENEXA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66215-4039
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-498-0005
Provider Business Mailing Address Fax Number:
913-754-0875

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11240 STRANG LINE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LENEXA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66215-4039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-498-0005
Provider Business Practice Location Address Fax Number:
913-754-0875
Provider Enumeration Date:
12/28/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  21-00009 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 27685045 . This is a "BCBS PROVIDER ID" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".