Provider Demographics
NPI:1881655967
Name:BROWN, JANE WARNE (MD)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:WARNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:91 STONEHAVEN CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-1945
Mailing Address - Country:US
Mailing Address - Phone:731-668-1845
Mailing Address - Fax:731-668-3607
Practice Address - Street 1:91 STONEHAVEN CIR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-1945
Practice Address - Country:US
Practice Address - Phone:731-668-1845
Practice Address - Fax:731-668-3607
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD66382085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A96839Medicare UPIN