Provider Demographics
NPI:1811973977
Name:BROWNE, GEORGE O III (PA)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:O
Last Name:BROWNE
Suffix:III
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2505
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-2505
Mailing Address - Country:US
Mailing Address - Phone:812-238-7783
Mailing Address - Fax:812-238-4506
Practice Address - Street 1:315 LANKFORD ST
Practice Address - Street 2:
Practice Address - City:CLAY CITY
Practice Address - State:IN
Practice Address - Zip Code:47841-1008
Practice Address - Country:US
Practice Address - Phone:812-939-2126
Practice Address - Fax:812-939-3414
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10000070A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00613721OtherRR
R33256Medicare UPIN
IN941090Z5Medicare PIN
IN854700CCCCMedicare PIN
IN252060XMedicare PIN
IN130910DDMedicare PIN