Provider Demographics
NPI:1407867666
Name:BROWN, RAYMOND SEAN (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:SEAN
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 PEERLESS XING NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-3764
Mailing Address - Country:US
Mailing Address - Phone:423-473-8001
Mailing Address - Fax:423-473-0926
Practice Address - Street 1:1065 PEERLESS XING NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3764
Practice Address - Country:US
Practice Address - Phone:423-473-8001
Practice Address - Fax:423-473-0926
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000034244208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3853338Medicaid
TN3853338Medicare ID - Type Unspecified
TN3853338Medicaid