Basic Information
| Provider Information | |||||||||
| NPI: | 1942278676 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | PAUL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 40850 | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85274 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4802629221 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1201 S 7 AVENUE | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022585111 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2006 | ||||||||
| LastUpdateDate: | 05/16/2016 | ||||||||
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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 | 207P00000X | AZ33003 | AZ | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 453051001 | 01 | GROUP HEALTH GRP | OTHER | AZ0728670 | 01 | AZ | BLUE CROSS BLUE SHIELD GR | OTHER | 3981220 | 01 | EVERCARE GRP | OTHER | 860373636 | 01 | AZ | HUMANA GROUP | OTHER | AW1436 | 01 | AZ | HEALTHNET GRP | OTHER |