Provider Demographics
NPI:1265241657
Name:BROWN, GUY PATRICK JR
Entity type:Individual
Prefix:
First Name:GUY
Middle Name:PATRICK
Last Name:BROWN
Suffix:JR
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 1:2307 MAGNOLIA RD NW
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:OH
Mailing Address - Zip Code:44643-9525
Mailing Address - Country:US
Mailing Address - Phone:330-418-8813
Mailing Address - Fax:
Practice Address - Street 1:3729 DEWEY DR NE
Practice Address - Street 2:
Practice Address - City:ZOARVILLE
Practice Address - State:OH
Practice Address - Zip Code:44656-8913
Practice Address - Country:US
Practice Address - Phone:330-859-5024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant