Provider Demographics
NPI:1346509486
Name:BROWNSON, MARK RYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:RYAN
Last Name:BROWNSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:27 MAIN ST
Mailing Address - Street 2:C301
Mailing Address - City:EDWARDS
Mailing Address - State:CO
Mailing Address - Zip Code:81632-8109
Mailing Address - Country:US
Mailing Address - Phone:970-569-3600
Mailing Address - Fax:970-569-3601
Practice Address - Street 1:27 MAIN ST
Practice Address - Street 2:C301
Practice Address - City:EDWARDS
Practice Address - State:CO
Practice Address - Zip Code:81632-8109
Practice Address - Country:US
Practice Address - Phone:970-569-3600
Practice Address - Fax:970-569-3601
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2015-06-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0055176207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1346509486Medicare PIN