Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35.077904 | OH |
N | 111NI0900X | Internist | 35.077904 | OH |
Y | 207RA0401X | Internist - Addiction Medicine | 35077904 | OH |
N | 208D00000X | General Practice Physician | 35077904 | OH |
NPI | 1407975790 |
---|---|
Provider Name | Judith L. Brown |
First Address | Cincinnati, OH 45202-1457 |
Second Address | Whitehall, OH 43213-2925 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 17/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1295011781 | (05) | OH |