Provider Demographics
NPI:1225250939
Name:J DAVID BROWN DPM
Entity Type:Organization
Organization Name:J DAVID BROWN DPM
Other - Org Name:AACI FOOT LEG & ANKLE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:J
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:480-759-6737
Mailing Address - Street 1:3011 S LINDSAY RD
Mailing Address - Street 2:#113
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295
Mailing Address - Country:US
Mailing Address - Phone:480-759-6737
Mailing Address - Fax:480-759-5404
Practice Address - Street 1:3011 S LINDSAY RD
Practice Address - Street 2:#113
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295
Practice Address - Country:US
Practice Address - Phone:480-759-6737
Practice Address - Fax:480-759-5404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU96980Medicare UPIN
AZ76494Medicare ID - Type UnspecifiedJ DAVID BROWN MEDICARE #
AZ76495Medicare ID - Type UnspecifiedMARY PETERS MEDICARE #
AZ4111890001Medicare NSC
AZU35276Medicare UPIN
AZZ76493Medicare ID - Type UnspecifiedGROUP MEDICARE PROVIDER #