Provider Demographics
NPI:1619295540
Name:BROWN, JOSEPH CLAY (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:CLAY
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:PO BOX 1737
Mailing Address - Street 2:N/A
Mailing Address - City:MONTICELLO
Mailing Address - State:KY
Mailing Address - Zip Code:42633-4737
Mailing Address - Country:US
Mailing Address - Phone:606-753-0293
Mailing Address - Fax:606-753-0291
Practice Address - Street 1:268 ROLLING HILLS BLVD.
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-2900
Practice Address - Country:US
Practice Address - Phone:606-753-0293
Practice Address - Fax:606-753-0291
Is Sole Proprietor?:No
Enumeration Date:2010-05-17
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2429207R00000X
KY46843208000000X, 207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100258320Medicaid
KY46843OtherKENTUCKY BOARD OF MEDICAL LICENSURE
KYR2429OtherLICENSE
KYK215822Medicare PIN
KY7100258320Medicaid
KYK215821Medicare PIN