Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 0104000378 | VA |
NPI | 1124271358 |
---|---|
Provider Name | Richard L Brown |
First Address | Clarksville, VA 23927-0933 |
Second Address | Clarksville, VA 23927-0933 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2008 |
Last Update Date | 31/10/2008 |