Provider Demographics
NPI:1386821841
Name:BROWN, GERALD E (DO)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:E
Last Name:BROWN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2575 LINDELL RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5409
Mailing Address - Country:US
Mailing Address - Phone:702-362-3937
Mailing Address - Fax:702-362-7935
Practice Address - Street 1:2575 LINDELL RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5409
Practice Address - Country:US
Practice Address - Phone:702-362-3937
Practice Address - Fax:702-362-7935
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV855207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
V30164Medicare PIN
NVF38761Medicare UPIN