Provider Demographics
NPI:1912212093
Name:BROWN, JEREMY RONALD (DO)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:RONALD
Last Name:BROWN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5715 KITTERY DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80911-3551
Mailing Address - Country:US
Mailing Address - Phone:719-392-3883
Mailing Address - Fax:719-390-6338
Practice Address - Street 1:5715 KITTERY DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80911-3551
Practice Address - Country:US
Practice Address - Phone:719-392-3883
Practice Address - Fax:719-390-6338
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO51197207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine