Provider Demographics
NPI:1376387373
Name:BROWN, PAUL FERGUSON JR
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:FERGUSON
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 1:2238 SALVADOR ST APT A
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-5305
Mailing Address - Country:US
Mailing Address - Phone:513-601-7891
Mailing Address - Fax:
Practice Address - Street 1:2238 SALVADOR ST APT A
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-5305
Practice Address - Country:US
Practice Address - Phone:513-601-7891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSY287737376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker