Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 3544-012 | WI |
NPI | 1235124751 |
---|---|
Provider Name | Dr. Donald G. Brown |
First Address | New Richmond, WI 54017-2430 |
Second Address | New Richmond, WI 54017-2430 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2005 |
Last Update Date | 28/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
38924200 | (05) | WI |
U75516 | (02) | WI |