Provider Demographics
NPI:1043417488
Name:BROWN, CRAIG BARRETT (DO)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:BARRETT
Last Name:BROWN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:4017 N FLAMING SKY PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-6198
Mailing Address - Country:US
Mailing Address - Phone:480-822-8041
Mailing Address - Fax:520-505-4598
Practice Address - Street 1:1501 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-0001
Practice Address - Country:US
Practice Address - Phone:520-626-6887
Practice Address - Fax:520-626-5183
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZR1037207R00000X
AZ005801207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
143847OtherAOA MEMBERSHIP ID
AZD03034321OtherIDENTIFCATION CARD
AZ5202011146OtherSTATE OF AZ DEPT. OF PUBLIC SAFETY LEVEL 1 FINGERPRINT CLEARANCE CARD
AZ00375050528OtherAMA-MEMBERSHIP
740539OtherNBOME
AZ005801OtherARIZONA MEDICAL LICENSE
AZ4254OtherABOIM CERTIFICATE NUMBER
AZ4254OtherABOIM CERTIFICATE NUMBER