1003235102 NPI number — MR. ISAIAH BROWN MD

Table of content: MR. ISAIAH BROWN MD (NPI 1003235102)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003235102 NPI number — MR. ISAIAH BROWN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
ISAIAH
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1003235102
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9744 W. BELL RD
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
SUN CITY
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85351
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-553-8346
Provider Business Mailing Address Fax Number:
623-404-4530

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9744 W. BELL RD
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
SUN CITY
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-553-8346
Provider Business Practice Location Address Fax Number:
623-404-4530
Provider Enumeration Date:
04/16/2014

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2086S0129X , with the licence number: ME158944 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 115879300 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com