Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 33209 | AZ |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 33209 | AZ |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 33209 | AZ |
NPI | 1306887088 |
---|---|
Provider Name | John Andrew Brown |
First Address | Phoenix, AZ 85023-1266 |
Second Address | Sun City West, AZ 85375-5855 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2006 |
Last Update Date | 22/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5550830001 | MEDICARE NSC SCW (01) | AZ |
5550830003 | MEDICARE NSC PEORIA (01) | AZ |
5550830007 | MEDICARE NSC DV (01) | AZ |
5550830010 | MEDICARE NSC GILBERT (01) | AZ |
908585 | (05) | AZ |
I02889 | (02) | AZ |
P00207825 | RR MEDICARE (01) | AZ |