Provider Demographics
NPI:1255362083
Name:BROWN, WILLIAM J (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3200 TROUP HWY
Mailing Address - Street 2:SUITE #200
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-8397
Mailing Address - Country:US
Mailing Address - Phone:903-533-8084
Mailing Address - Fax:903-535-9543
Practice Address - Street 1:3200 TROUP HWY
Practice Address - Street 2:SUITE #200
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-8397
Practice Address - Country:US
Practice Address - Phone:903-533-8084
Practice Address - Fax:903-535-9543
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXE0408207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD48008Medicare UPIN
TX83V281Medicare ID - Type Unspecified