1962572693 NPI number — WILLIAM P. BROWN, D.C., INC.

Table of content: (NPI 1962572693)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962572693 NPI number — WILLIAM P. BROWN, D.C., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM P. BROWN, D.C., INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1962572693
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/15/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13003 ECKEL JUNCTION RD STE 105
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PERRYSBURG
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43551-7633
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-874-0405
Provider Business Mailing Address Fax Number:
419-874-0427

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13003 ECKEL JUNCTION RD STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PERRYSBURG
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-874-0405
Provider Business Practice Location Address Fax Number:
419-874-0427
Provider Enumeration Date:
11/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
P.
Authorized Official Title or Position:
CHIROPRACTOR
Authorized Official Telephone Number:
419-874-0405

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2090 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5349505 . This is a "AETNA" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 274800180005 . This is a "MEDICAL MUTUAL OF OHIO" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0125993 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 157124227 . This is a "PPOM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 725885 . This is a "FAMILY HEALTH PLAN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2580173 . This is a "CIGNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000193661 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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