Provider Demographics
NPI:1407873904
Name:BROWN, LOY D (OD)
Entity Type:Individual
Prefix:DR
First Name:LOY
Middle Name:D
Last Name:BROWN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 E 400 N
Mailing Address - Street 2:#4A
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-6186
Mailing Address - Country:US
Mailing Address - Phone:435-586-0700
Mailing Address - Fax:435-865-0784
Practice Address - Street 1:51 E 400 N
Practice Address - Street 2:#4A
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-6186
Practice Address - Country:US
Practice Address - Phone:435-586-0700
Practice Address - Fax:435-865-0784
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT111328 9934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000009802Medicare ID - Type Unspecified