Provider Demographics
NPI:1821301987
Name:ROBERT JEFFREY BROWN PSC
Entity Type:Organization
Organization Name:ROBERT JEFFREY BROWN PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-282-3413
Mailing Address - Street 1:211 SPARKS AVE
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3732
Mailing Address - Country:US
Mailing Address - Phone:812-282-3413
Mailing Address - Fax:
Practice Address - Street 1:211 SPARKS AVE
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3732
Practice Address - Country:US
Practice Address - Phone:812-282-3413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000297A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
791350972OtherRAILROAD MEDICARE
791350972OtherRAILROAD MEDICARE
T34642Medicare UPIN