Provider Demographics
NPI:1437534948
Name:BROWN, JOHN ANDREW (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ANDREW
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3950 KRESGE WAY STE 207
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4637
Mailing Address - Country:US
Mailing Address - Phone:502-893-0220
Mailing Address - Fax:502-893-0563
Practice Address - Street 1:740 S LIMESTONE
Practice Address - Street 2:STE D201
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536
Practice Address - Country:US
Practice Address - Phone:859-323-0079
Practice Address - Fax:859-257-6868
Is Sole Proprietor?:No
Enumeration Date:2015-07-26
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY51434207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100547420Medicaid