Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | POD679 | TN |
Y | 222Z00000X | Podiatrist | POD679 | TN |
NPI | 1053335273 |
---|---|
Provider Name | Dr. Damieon Brown |
First Address | Chattanooga, TN 37421 |
Second Address | Jasper, TN 37347-0417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 17/03/2018 |