Provider Demographics
NPI:1891807814
Name:BROWN, CAROLYN VIRDEN (MD MPH)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:VIRDEN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2231 JORDAN AVE
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-8050
Mailing Address - Country:US
Mailing Address - Phone:907-789-1812
Mailing Address - Fax:907-789-7168
Practice Address - Street 1:2231 JORDAN AVE
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-8050
Practice Address - Country:US
Practice Address - Phone:907-789-1812
Practice Address - Fax:907-789-7168
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK907207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMOO9071Medicaid
VT1357880Medicare UPIN
AK152840Medicare ID - Type Unspecified