Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 01058901A | IN |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 35789 | KY |
NPI | 1003865304 |
---|---|
Provider Name | Dr. Michael J Brown |
First Address | Louisville, KY 40207-4714 |
Second Address | Louisville, KY 40207-4714 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2006 |
Last Update Date | 21/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000335350 | INDIANA ANTHEM NUMBER (01) | IN |
000000335350 | KENTUCKY ANTHEM NUMBER (01) | KY |
200458400 | INDIANA GROUP MEDICAID # (01) | IN |
200483440A | (05) | IN |
2445466000 | PASSPORT ADVANTAGE # (01) | KY |
50004083 | KENTUCKY PASSPORT # (01) | KY |
64078066 | (05) | KY |
7063240 | CIGNA (01) | |
7455590 | AETNA (01) | |
I05792 | (02) | KY |
P00163950 | RAILROAD MEDICARE NUMBER (01) |