Provider Demographics
NPI:1053335273
Name:BROWN, DAMIEON (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAMIEON
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2288 GUNBARREL ROAD
Mailing Address - Street 2:#154-233
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421
Mailing Address - Country:US
Mailing Address - Phone:423-942-1252
Mailing Address - Fax:423-942-1265
Practice Address - Street 1:3697 MAIN ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TN
Practice Address - Zip Code:37347-0417
Practice Address - Country:US
Practice Address - Phone:423-942-1252
Practice Address - Fax:423-942-1265
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPOD679213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN480027196Medicare PIN
GA480027196Medicare PIN
GA511I480007Medicare PIN