Provider Demographics
NPI:1356668644
Name:HOSEA E BROWN MD INC
Entity Type:Organization
Organization Name:HOSEA E BROWN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HOSEA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-320-9464
Mailing Address - Street 1:PO BOX 1503
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92263-1503
Mailing Address - Country:US
Mailing Address - Phone:760-320-9464
Mailing Address - Fax:760-320-6244
Practice Address - Street 1:3755 KARICIO LN
Practice Address - Street 2:SUITE 2A
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86303-6836
Practice Address - Country:US
Practice Address - Phone:928-445-4645
Practice Address - Fax:760-320-6244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-26
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24719207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ365975Medicaid
AZAZ0803500OtherBLUE CROSS BLUE SHIELD
AZAZ0803500OtherBLUE CROSS BLUE SHIELD
AZ365975Medicaid