Provider Demographics
NPI:1215540307
Name:JONATHAN P BROWER MD LLC
Entity Type:Organization
Organization Name:JONATHAN P BROWER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:BROWER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-738-8066
Mailing Address - Street 1:113 WICKENDEN ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4364
Mailing Address - Country:US
Mailing Address - Phone:401-453-0120
Mailing Address - Fax:401-453-0198
Practice Address - Street 1:113 WICKENDEN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4364
Practice Address - Country:US
Practice Address - Phone:401-453-0120
Practice Address - Fax:401-453-0198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty