Provider Demographics
NPI:1679568984
Name:BROWN, WILLARD MARTIN III (DO)
Entity Type:Individual
Prefix:
First Name:WILLARD
Middle Name:MARTIN
Last Name:BROWN
Suffix:III
Gender:M
Credentials:DO
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Mailing Address - Street 1:102 HUMPHREY LN
Mailing Address - Street 2:102 HUMPHREY LANE
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-2282
Mailing Address - Country:US
Mailing Address - Phone:413-781-2287
Mailing Address - Fax:413-732-4504
Practice Address - Street 1:1985 MAIN ST
Practice Address - Street 2:304
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-1095
Practice Address - Country:US
Practice Address - Phone:413-736-5491
Practice Address - Fax:413-732-4504
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2008-09-10
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Provider Licenses
StateLicense IDTaxonomies
MA38201207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine