Provider Demographics
NPI:1609976612
Name:BROWN, THOMAS WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WILLIAM
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 HEALTHWEST DR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-2031
Mailing Address - Country:US
Mailing Address - Phone:334-792-9500
Mailing Address - Fax:334-793-1815
Practice Address - Street 1:1340 HIGHWAY 231 S STE 6
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36081-3012
Practice Address - Country:US
Practice Address - Phone:334-670-5475
Practice Address - Fax:334-670-5446
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14492207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00438776AMedicaid
AL51081378OtherBLUE CROSS & BLUE SHILED
AL000087124Medicaid
AL51087124OtherBLUE CROSS & BLUE SHIELD
AL000081378Medicaid
110052489OtherPALMETTO GBA- RR MEDICARE
GA00438776AMedicaid
AL000081378Medicaid
E20740Medicare UPIN
AL000081378Medicare ID - Type Unspecified
AL0342610001Medicare NSC