Provider Demographics
NPI:1760470744
Name:BROWN, WILLIAM JEFF II (AUD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JEFF
Last Name:BROWN
Suffix:II
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10509 MEETING STREET
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40059
Mailing Address - Country:US
Mailing Address - Phone:502-893-5105
Mailing Address - Fax:502-893-5104
Practice Address - Street 1:10509 MEETING STREET
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40059
Practice Address - Country:US
Practice Address - Phone:502-893-5105
Practice Address - Fax:502-893-5104
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0322231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY640587001OtherRAILROAD MEDICARE
KYQ11492Medicare UPIN
KY0911401Medicare PIN