Provider Demographics
NPI:1437336880
Name:RICHARD D. BROWN, M.D.
Entity Type:Organization
Organization Name:RICHARD D. BROWN, M.D.
Other - Org Name:WESTERN MOUNTAIN OPHTHALMOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOOTHAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-778-2245
Mailing Address - Street 1:628 WILTON RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-6138
Mailing Address - Country:US
Mailing Address - Phone:207-778-2245
Mailing Address - Fax:207-779-1098
Practice Address - Street 1:628 WILTON RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938
Practice Address - Country:US
Practice Address - Phone:207-778-2245
Practice Address - Fax:207-779-1098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME014299332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME133430199Medicaid
ME040443OtherANTHEM
ME1297590001Medicare NSC