Provider Demographics
NPI:1245223577
Name:BROWN, ANN DAIL (MD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:DAIL
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:BROWN
Other - Last Name:THOMASON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:DEPT 978
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-756-1231
Mailing Address - Fax:901-756-1264
Practice Address - Street 1:7690 WOLF RIVER CIR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1744
Practice Address - Country:US
Practice Address - Phone:901-756-1231
Practice Address - Fax:901-756-1264
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12410207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1522482Medicaid
TN4342202OtherBCBS TN
TN4342202OtherBCBS TN
TN1522482Medicaid
AB9126310OtherDEA