Provider Demographics
NPI:1265674279
Name:BROWN, MICHAEL BRIEN (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRIEN
Last Name:BROWN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:3744 S TIMBERLINE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4333
Mailing Address - Country:US
Mailing Address - Phone:970-495-0506
Mailing Address - Fax:970-495-0485
Practice Address - Street 1:3744 S TIMBERLINE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4333
Practice Address - Country:US
Practice Address - Phone:970-495-0506
Practice Address - Fax:970-495-0485
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0051520207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000106219Medicaid
COCOA107586Medicare PIN
COP01080609OtherMEDICARE RAILROAD
COCOA107582Medicare PIN