Provider Demographics
NPI:1750856688
Name:BROWN, WILLIAM ISAAC
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ISAAC
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1532 SPRING PARK WALK
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-0060
Mailing Address - Country:US
Mailing Address - Phone:209-715-7514
Mailing Address - Fax:
Practice Address - Street 1:5050 MADISON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-1491
Practice Address - Country:US
Practice Address - Phone:513-272-2800
Practice Address - Fax:513-272-2807
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-08
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174400000XOther Service ProvidersSpecialist