Basic Information
| Provider Information | |||||||||
| NPI: | 1649452509 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | EARL | ||||||||
| MiddleName: | JOSEPH | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | ETSU QUILLEN COLLEGE OF MEDICINE | ||||||||
| Address2: | PO BOX 70568 | ||||||||
| City: | JOHNSON CITY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376140568 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234396210 | ||||||||
| FaxNumber: | 4234398060 | ||||||||
| Practice Location | |||||||||
| Address1: | DOGWOOD LANE | ||||||||
| Address2: | DEPARTMENT OF PATHOLOGY VAMC BDG 1 RM B-30 | ||||||||
| City: | MOUNTAIN HOME | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37684 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234396210 | ||||||||
| FaxNumber: | 4234398060 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2007 | ||||||||
| LastUpdateDate: | 12/03/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | MD0000017995 | TN | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.