Provider Demographics
NPI:1942239256
Name:BROWN, ERIK MILO (DC)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:MILO
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331A JUNGERMANN RD
Mailing Address - Street 2:
Mailing Address - City:ST PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-5351
Mailing Address - Country:US
Mailing Address - Phone:636-928-5588
Mailing Address - Fax:636-922-0071
Practice Address - Street 1:331A JUNGERMANN RD
Practice Address - Street 2:
Practice Address - City:ST PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-5351
Practice Address - Country:US
Practice Address - Phone:636-928-5588
Practice Address - Fax:636-922-0071
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001029037111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO652787OtherACN
MO431738059BROOtherMERCY
MO469597OtherHEALTHLINK
MO7235719OtherAETNA
MO157568OtherBCBS
MO157568OtherBCBS
MOU93602Medicare UPIN