Provider Demographics
NPI:1780675991
Name:BROWN, JEFFREY W (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:W
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:426 N PLEASANTBURG DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-2187
Mailing Address - Country:US
Mailing Address - Phone:864-271-0001
Mailing Address - Fax:864-271-2310
Practice Address - Street 1:426 N PLEASANTBURG DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2187
Practice Address - Country:US
Practice Address - Phone:864-271-0001
Practice Address - Fax:864-271-2310
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC998111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T25076Medicare UPIN