Provider Demographics
NPI:1205850666
Name:BROWN, JASON W (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:W
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1034 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-2945
Mailing Address - Country:US
Mailing Address - Phone:814-373-2335
Mailing Address - Fax:814-373-2338
Practice Address - Street 1:16792 CONNEAUT LAKE RD
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3748
Practice Address - Country:US
Practice Address - Phone:814-373-2335
Practice Address - Fax:814-373-2338
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2016-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD425457207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD425457OtherMEDICAL LICENSE