Provider Demographics
NPI:1811905284
Name:BROWN, TIMOTHY NEAL (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:NEAL
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1111 RIDGEWAY DR
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-1065
Mailing Address - Country:US
Mailing Address - Phone:260-407-8000
Mailing Address - Fax:260-407-8004
Practice Address - Street 1:1501 HARTFORD ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904-2134
Practice Address - Country:US
Practice Address - Phone:765-423-6011
Practice Address - Fax:260-407-8004
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01032874A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100324000Medicaid
IN100324000Medicaid
IN809640RRMedicare PIN
INP00431375Medicare PIN