Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 0383 | AZ |
NPI | 1073511879 |
---|---|
Provider Name | J. David Brown |
First Address | Gilbert, AZ 85295-4332 |
Second Address | Gilbert, AZ 85295-4332 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 12/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U35276 | (02) | AZ |