1386797025 NPI number — DR. WILLIAM ROCKY BROWN III MA, CAC

Table of content: DR. WILLIAM ROCKY BROWN III MA, CAC (NPI 1386797025)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386797025 NPI number — DR. WILLIAM ROCKY BROWN III MA, CAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
WILLIAM
Provider Middle Name:
ROCKY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
III
Provider Credential Text:
MA, CAC
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:
1386797025
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:
214 EDWARDS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19013-3131
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-876-9006
Provider Business Mailing Address Fax Number:
610-876-7455

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2600 W 9TH ST
Provider Second Line Business Practice Location Address:
4TH FLOOR
Provider Business Practice Location Address City Name:
CHESTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19013-2040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-497-7200
Provider Business Practice Location Address Fax Number:
610-497-7654
Provider Enumeration Date:
01/18/2007

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: 101YA0400X , with the licence number:  4152 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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