Provider Demographics
NPI:1336104397
Name:BROWN, JULIA A (MD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:A
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:9880 ANGIES WAY STE 420
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2850
Practice Address - Country:US
Practice Address - Phone:502-394-6200
Practice Address - Fax:502-394-6210
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34303207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000350616OtherANTHEM / NMA
000052154JOtherHUMANA / NMA
0662555002OtherCIGNA / NMA
1183758OtherCHA / NMA
2447990000OtherPASSPORT ADVANTAGE
50006769OtherPASSPORT / NMA
KY64343031Medicaid
KYP00212977OtherRAILROAD MEDICARE
KY64343031Medicaid
000052154JOtherHUMANA / NMA