Provider Demographics
NPI:1750519724
Name:BROWN, MATTHEW J (AUD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:BROWN
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
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Mailing Address - Street 1:1520 WAKARUSA DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-1802
Mailing Address - Country:US
Mailing Address - Phone:785-856-4200
Mailing Address - Fax:785-856-4204
Practice Address - Street 1:1520 WAKARUSA DR
Practice Address - Street 2:SUITE B
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-1802
Practice Address - Country:US
Practice Address - Phone:785-856-4200
Practice Address - Fax:785-856-4204
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-29
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KST-AUF-2017231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSKA2648001OtherMEDICARE PTAN