Provider Demographics
NPI:1245412055
Name:JOHN G BROWN P A
Entity Type:Organization
Organization Name:JOHN G BROWN P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GALEN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:850-438-4141
Mailing Address - Street 1:1901 N 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-4535
Mailing Address - Country:US
Mailing Address - Phone:850-438-4141
Mailing Address - Fax:850-438-9456
Practice Address - Street 1:1901 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-4535
Practice Address - Country:US
Practice Address - Phone:850-438-4141
Practice Address - Fax:850-438-9456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0005173261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD60785Medicare UPIN
FL82984YMedicare PIN
FLAG752Medicare PIN