Provider Demographics
NPI:1295812535
Name:BROWN, DENNIS JAMES (MD)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:JAMES
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 1:3465 SOUTHAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3867
Mailing Address - Country:US
Mailing Address - Phone:775-324-7926
Mailing Address - Fax:
Practice Address - Street 1:3465 SOUTHAMPTON DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3867
Practice Address - Country:US
Practice Address - Phone:775-324-7926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV4094207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4094Medicare ID - Type Unspecified
C95832Medicare UPIN