Provider Demographics
NPI:1407173701
Name:BROWN, DAVID KENNETH (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KENNETH
Last Name:BROWN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2150 NOLL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-7604
Mailing Address - Country:US
Mailing Address - Phone:717-299-8933
Mailing Address - Fax:717-299-5635
Practice Address - Street 1:2150 NOLL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-7604
Practice Address - Country:US
Practice Address - Phone:717-299-8933
Practice Address - Fax:717-299-5635
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS016743208000000X, 208000000X
DEC2-0009577208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics