Provider Demographics
NPI:1528021763
Name:BROWN, REBECCA JEAN WILLIAMSON (OD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:JEAN WILLIAMSON
Last Name:BROWN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:JEAN
Other - Last Name:WILLIAMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:389 N ELLSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-2805
Mailing Address - Country:US
Mailing Address - Phone:330-332-1200
Mailing Address - Fax:330-332-1200
Practice Address - Street 1:389 N ELLSWORTH AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-2805
Practice Address - Country:US
Practice Address - Phone:330-332-1200
Practice Address - Fax:330-332-1200
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5423152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist