Provider Demographics
NPI:1962835645
Name:BROWN, BARRY NEAL
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:NEAL
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3745 OAK SHADE CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-5840
Mailing Address - Country:US
Mailing Address - Phone:901-490-9605
Mailing Address - Fax:
Practice Address - Street 1:3745 OAK SHADE CV
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-5840
Practice Address - Country:US
Practice Address - Phone:901-490-9605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46-3432488253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care