1346509486 NPI number — DR. MARK RYAN BROWNSON M.D.

Table of content: DR. MARK RYAN BROWNSON M.D. (NPI 1346509486)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346509486 NPI number — DR. MARK RYAN BROWNSON M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWNSON
Provider First Name:
MARK
Provider Middle Name:
RYAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1346509486
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
27 MAIN ST
Provider Second Line Business Mailing Address:
C301
Provider Business Mailing Address City Name:
EDWARDS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81632-8109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-569-3600
Provider Business Mailing Address Fax Number:
970-569-3601

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
27 MAIN ST
Provider Second Line Business Practice Location Address:
C301
Provider Business Practice Location Address City Name:
EDWARDS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81632-8109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-569-3600
Provider Business Practice Location Address Fax Number:
970-569-3601
Provider Enumeration Date:
05/09/2012

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: 207P00000X , with the licence number:  DR.0055176 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com