Provider Demographics
NPI:1720146509
Name:BROWN, JOHN M (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:BROWN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 W MARKHAM ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3328
Mailing Address - Country:US
Mailing Address - Phone:501-227-0184
Mailing Address - Fax:501-227-0187
Practice Address - Street 1:5700 W MARKHAM ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3328
Practice Address - Country:US
Practice Address - Phone:501-227-0184
Practice Address - Fax:501-227-0187
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-1231207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR134228003Medicaid
AR390016OtherHEALTHLINK
AR90361100040OtherQUALCHOICE
AR5339013OtherAETNA
AR0120617OtherUNITEDHEALTHCARE
ARG68546Medicare UPIN
AR134228003Medicare PIN
AR390016OtherHEALTHLINK
AR90361100040OtherQUALCHOICE