Provider Demographics
NPI:1366753188
Name:BROWN, JEFFREY KIPLYN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:KIPLYN
Last Name:BROWN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3671 BURNING BUSH RD
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-5725
Mailing Address - Country:US
Mailing Address - Phone:423-653-6351
Mailing Address - Fax:706-866-1845
Practice Address - Street 1:3625 BATTLEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:FT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-4001
Practice Address - Country:US
Practice Address - Phone:706-866-1839
Practice Address - Fax:706-866-1845
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH020388183500000X
TN0000034045183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist