Individual
DR. GARRY J BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1501 N OAKLAND AVE, BOLIVAR, MO 65613-3020
(417) 326-7200
(417) 326-7201
Mailing address
PO BOX 256, SALINA, KS 67402-0256
(785) 823-0633
(785) 823-0658
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
2005041207
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146240006
PTAN
MO
05
—
161641103
—
AR
01
—
16701011
MEDICARE
KS
05
—
200721240A
—
KS
05
—
20091105
—
MO
Enumeration date
01/25/2007
Last updated
01/12/2021
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