Provider Demographics
NPI:1174523740
Name:BROWN, PEGGY J (MD)
Entity type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:J
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 MARION ST
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4845
Mailing Address - Country:US
Mailing Address - Phone:501-278-5610
Mailing Address - Fax:501-278-5614
Practice Address - Street 1:609 MARION ST
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4845
Practice Address - Country:US
Practice Address - Phone:501-278-5610
Practice Address - Fax:501-278-5614
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARN80822084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
54478Medicare ID - Type Unspecified
A99435Medicare UPIN