Provider Demographics
NPI:1093754327
Name:BROWN, JOHN P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:854 W JAMES CAMPBELL BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4659
Mailing Address - Country:US
Mailing Address - Phone:931-381-9338
Mailing Address - Fax:931-381-9266
Practice Address - Street 1:1222 TROTWOOD AVE
Practice Address - Street 2:SUITE 603
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-6436
Practice Address - Country:US
Practice Address - Phone:931-381-9338
Practice Address - Fax:931-381-9266
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2014-05-05
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Provider Licenses
StateLicense IDTaxonomies
TN5640208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2003565OtherBLUE CROSS BLUE SHIELD
TN3710089Medicaid
TN3156662Medicaid
TN3156662Medicare ID - Type Unspecified
TN3156662Medicaid
TN3710089Medicaid