Provider Demographics
NPI:1669459434
Name:BROWN, JULIA KEELING (MD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:KEELING
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:40069-1228
Mailing Address - Country:US
Mailing Address - Phone:859-336-7795
Mailing Address - Fax:859-336-7020
Practice Address - Street 1:219 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:KY
Practice Address - Zip Code:40069-1228
Practice Address - Country:US
Practice Address - Phone:859-336-7795
Practice Address - Fax:859-336-7020
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY28949207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64289499Medicaid
KYF64501Medicare UPIN
KY0576602Medicare PIN