Provider Demographics
NPI:1831168913
Name:BROWN, HUNTER LEE (MD)
Entity type:Individual
Prefix:
First Name:HUNTER
Middle Name:LEE
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 VIRGINIA DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7317
Mailing Address - Country:US
Mailing Address - Phone:870-698-1846
Mailing Address - Fax:870-793-5229
Practice Address - Street 1:501 VIRGINIA DR
Practice Address - Street 2:SUITE A
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7317
Practice Address - Country:US
Practice Address - Phone:870-698-1846
Practice Address - Fax:870-793-5229
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC6795208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR111496001Medicaid
C67892Medicare UPIN
AR50687Medicare ID - Type Unspecified