Provider Demographics
NPI:1184608267
Name:BROWN, MORRIS LAMAR (MD)
Entity type:Individual
Prefix:DR
First Name:MORRIS
Middle Name:LAMAR
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 DEER RUN RD
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4924
Mailing Address - Country:US
Mailing Address - Phone:937-689-4719
Mailing Address - Fax:
Practice Address - Street 1:1080 DEER RUN RD
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4924
Practice Address - Country:US
Practice Address - Phone:937-689-4719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35038418207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4013675OtherAETNA
OH421534506021OtherCHAMPUS/TRICARE/HEALTHNET
OH000000384724OtherANTHEM
OH35038418BOtherMEDICAL LICENSE
OH421534506099OtherCARESOURCE
OH0347360Medicaid
OH4013675OtherAETNA
OHA77641Medicare UPIN
OHBR0448879Medicare PIN