Provider Demographics
NPI:1144576422
Name:BROWN, ADAM DOUGLAS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:DOUGLAS
Last Name:BROWN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 LEESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-2136
Mailing Address - Country:US
Mailing Address - Phone:859-259-0965
Mailing Address - Fax:859-259-0971
Practice Address - Street 1:1600 LEESTOWN RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-2136
Practice Address - Country:US
Practice Address - Phone:859-259-0965
Practice Address - Fax:859-259-0971
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY013656183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY013656OtherKENTUCKY BOARD OF PHARMACY