Provider Demographics
NPI:1447597737
Name:BROWN, JOHN ROBERTSON
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ROBERTSON
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6311 DEBARR RD
Mailing Address - Street 2:SUITE L-2
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-1787
Mailing Address - Country:US
Mailing Address - Phone:907-336-3365
Mailing Address - Fax:907-336-3397
Practice Address - Street 1:6311 DEBARR RD
Practice Address - Street 2:SUITE L-2
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-1787
Practice Address - Country:US
Practice Address - Phone:907-336-3365
Practice Address - Fax:907-336-3397
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker