Provider Demographics
NPI:1689057135
Name:BROWN, COLIN ELLIOT (MD)
Entity Type:Individual
Prefix:DR
First Name:COLIN
Middle Name:ELLIOT
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 1:240 MINNESOTA ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-6200
Mailing Address - Country:US
Mailing Address - Phone:605-718-5123
Mailing Address - Fax:605-646-2020
Practice Address - Street 1:240 MINNESOTA ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-6200
Practice Address - Country:US
Practice Address - Phone:605-718-5123
Practice Address - Fax:605-646-2020
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7528207R00000X
SC82443207W00000X
SD12043207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine