Provider Demographics
NPI:1780728089
Name:BROWN, PHILLIP PENDLETON I (MD)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:PENDLETON
Last Name:BROWN
Suffix:I
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:518 PARK CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-3430
Mailing Address - Country:US
Mailing Address - Phone:615-383-2760
Mailing Address - Fax:615-383-7612
Practice Address - Street 1:518 PARK CENTER AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-3430
Practice Address - Country:US
Practice Address - Phone:615-383-2760
Practice Address - Fax:615-383-7612
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9803208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB03501Medicare UPIN