1972797835 NPI number — STEVEN BROWN MD PC

Table of content: (NPI 1972797835)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972797835 NPI number — STEVEN BROWN MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEVEN BROWN MD PC
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:
1972797835
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 97
Provider Second Line Business Mailing Address:
1667 LUCERNE DR STE A
Provider Business Mailing Address City Name:
MINDEN
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89423
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-782-9118
Provider Business Mailing Address Fax Number:
775-782-7992

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1667 LUCERNE DR
Provider Second Line Business Practice Location Address:
STE A
Provider Business Practice Location Address City Name:
MINDEN
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-782-9118
Provider Business Practice Location Address Fax Number:
775-782-7992
Provider Enumeration Date:
09/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KOPSHO
Authorized Official First Name:
SUE
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
775-782-9118

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  7273 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: CC0029 . This is a "B/C" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".




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