Provider Demographics
NPI:1225398019
Name:BROWN, BRANDON CW (MD)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:CW
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 TOWN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:MO
Mailing Address - Zip Code:63334-2803
Mailing Address - Country:US
Mailing Address - Phone:573-324-2241
Mailing Address - Fax:573-324-2617
Practice Address - Street 1:8 TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:MO
Practice Address - Zip Code:63334-2803
Practice Address - Country:US
Practice Address - Phone:573-324-2241
Practice Address - Fax:573-324-2617
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE28700207Q00000X
MO2022012436207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine