Provider Demographics
NPI:1780615484
Name:BROWN, STEVEN RALPH (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RALPH
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 OIL WELL RD
Mailing Address - Street 2:A
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-8015
Mailing Address - Country:US
Mailing Address - Phone:731-668-3399
Mailing Address - Fax:731-664-5455
Practice Address - Street 1:231 OIL WELL RD
Practice Address - Street 2:A
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-8015
Practice Address - Country:US
Practice Address - Phone:731-668-3399
Practice Address - Fax:731-664-5455
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC257111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNT47505Medicare UPIN
TN3672333Medicare ID - Type Unspecified