Provider Demographics
NPI:1861466427
Name:BROWN, JOSEPH A (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:BROWN
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Gender:M
Credentials:DO
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Mailing Address - Street 1:331 LAIDLEY ST
Mailing Address - Street 2:STE 301
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-1605
Mailing Address - Country:US
Mailing Address - Phone:304-346-4400
Mailing Address - Fax:304-346-0704
Practice Address - Street 1:5425 N MAYO TRL
Practice Address - Street 2:SUITE 202
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-2966
Practice Address - Country:US
Practice Address - Phone:606-200-5353
Practice Address - Fax:606-200-5352
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2017-07-25
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Provider Licenses
StateLicense IDTaxonomies
KY03049207W00000X, 207WX0107X
VA0102202411207W00000X
WV3034207W00000X, 207WX0107X
TXM1538207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100019700Medicaid
KY3703742Medicare PIN
KYK130151Medicare PIN
KYI33199Medicare UPIN
KY3703742Medicare PIN