Provider Demographics
NPI:1821069683
Name:BROWN, RANDALL LINCOLN (MD)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:LINCOLN
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1415 ELM ST
Mailing Address - Street 2:NH EYE ASSOCIATES PA
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1325
Mailing Address - Country:US
Mailing Address - Phone:603-669-3925
Mailing Address - Fax:603-665-9360
Practice Address - Street 1:1415 ELM ST
Practice Address - Street 2:NH EYE ASSOCIATES PA
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1325
Practice Address - Country:US
Practice Address - Phone:603-669-3925
Practice Address - Fax:603-669-0380
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH6551207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH82183740Medicaid
NHRE0036Medicare ID - Type Unspecified
NH82183740Medicaid