Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN0400X | Neurology | 1563 | AL |
Y | 111NN0400X | Neurology | 1563 0265 | AL |
NPI | 1477562411 |
---|---|
Provider Name | Dr. John Douglas Brown |
First Address | Gulf Shores, AL 36542-4412 |
Second Address | Foley, AL 36535-1919 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 15/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U48453 | (02) | AL |