Provider Demographics
NPI:1588628705
Name:BROWN, PAUL GARLAND (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:GARLAND
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1616 N MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-4474
Mailing Address - Country:US
Mailing Address - Phone:276-783-1827
Mailing Address - Fax:276-783-2879
Practice Address - Street 1:1616 N MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-4398
Practice Address - Country:US
Practice Address - Phone:276-783-8123
Practice Address - Fax:276-783-1820
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA010135636207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA240903OtherANTHEM BCBS
VA515407OtherSOUTHERN HEALTH
VA1513316OtherUMWA
VA519974OtherVALUE OPTIONS
VA519974OtherVALUE OPTIONS
VA005619041Medicaid
VA080120184OtherRAILROAD MEDICARE
VA240903OtherANTHEM BCBS