Provider Demographics
NPI:1295784684
Name:BROWN FAMILY PRACTICE CLINIC
Entity type:Organization
Organization Name:BROWN FAMILY PRACTICE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:620-457-8100
Mailing Address - Street 1:PO BOX 196
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE
Mailing Address - State:KS
Mailing Address - Zip Code:66724
Mailing Address - Country:US
Mailing Address - Phone:316-281-3700
Mailing Address - Fax:316-282-4322
Practice Address - Street 1:307 N HOSPITAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:GIRARD
Practice Address - State:KS
Practice Address - Zip Code:66743-2014
Practice Address - Country:US
Practice Address - Phone:620-457-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty