Provider Demographics
NPI:1295929610
Name:JOHN H BROWN JR MD PC
Entity type:Organization
Organization Name:JOHN H BROWN JR MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:HUNN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:843-478-8410
Mailing Address - Street 1:PO BOX 1998
Mailing Address - Street 2:
Mailing Address - City:FOLLY BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29439-1998
Mailing Address - Country:US
Mailing Address - Phone:843-478-8410
Mailing Address - Fax:
Practice Address - Street 1:8383 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-6039
Practice Address - Country:US
Practice Address - Phone:843-478-8410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 130391208100000X
SC23036283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes283X00000XHospitalsRehabilitation Hospital
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCH57080Medicare UPIN
FLIV228ZMedicare PIN