Provider Demographics
NPI:1538141734
Name:BROWNE, JERRY L (MD)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:L
Last Name:BROWNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 S GILBERT ST STE 2
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-1747
Mailing Address - Country:US
Mailing Address - Phone:319-688-7376
Mailing Address - Fax:319-358-2628
Practice Address - Street 1:500 E MARKET ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2633
Practice Address - Country:US
Practice Address - Phone:319-339-0300
Practice Address - Fax:319-339-3906
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA30560207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP00207344OtherRAILROAD MEDICARE
IA1124834Medicaid
IA1538141734Medicaid
IA55157OtherWELLMARK BC/BS IOWA
IA55157OtherWELLMARK BC/BS IOWA
IA1538141734Medicaid
IAI1083Medicare PIN