Provider Demographics
NPI:1346355922
Name:TIMOTHY A BROWN MD PC
Entity Type:Organization
Organization Name:TIMOTHY A BROWN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:ALDEN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-282-0404
Mailing Address - Street 1:6 CHESAPEAKE ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LYNDORA
Mailing Address - State:PA
Mailing Address - Zip Code:16045
Mailing Address - Country:US
Mailing Address - Phone:724-282-0404
Mailing Address - Fax:724-282-9876
Practice Address - Street 1:6 CHESAPEAKE ST
Practice Address - Street 2:SUITE 205
Practice Address - City:LYNDORA
Practice Address - State:PA
Practice Address - Zip Code:16045
Practice Address - Country:US
Practice Address - Phone:724-282-0404
Practice Address - Fax:724-282-9876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2008-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD026005E207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADF7372OtherRAILROAD MEDICARE
PADF7372OtherRAILROAD MEDICARE