Provider Demographics
NPI:1225036049
Name:BROWN, MYRON O (DC)
Entity Type:Individual
Prefix:DR
First Name:MYRON
Middle Name:O
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:MR
Other - First Name:MYRON
Other - Middle Name:O
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3704B CLARKSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37218-2202
Mailing Address - Country:US
Mailing Address - Phone:615-244-1942
Mailing Address - Fax:615-244-1952
Practice Address - Street 1:3704B CLARKSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37218-2202
Practice Address - Country:US
Practice Address - Phone:615-244-1942
Practice Address - Fax:615-244-1952
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1566111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1836321OtherFIRST HEALTH
TN10833857OtherCAQH
TN4017452OtherBCBS OF TN
TN669377OtherUNITED HEALTHCARE
TN621865622OtherCHAMPUS TRICARE
TNU88473Medicare UPIN
TN669377OtherUNITED HEALTHCARE