Individual
DR. JONATHAN THOMAS BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 531-4262
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
(903) 531-5000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
P0174
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
283578701
—
TX
05
—
283578702
—
TX
05
—
283578703
—
TX
05
—
283578704
—
TX
01
—
75-0818167-022
TRICARE
TX
01
—
75-0818167-044
TRICARE
TX
01
—
75-2616977-001
TRICARE
TX
01
—
75-2616977-002
TRICARE
TX
01
—
75-2616977-028
TRICARE
TX
01
—
750818167015
TRICARE
TX
01
—
750818167048
TRICARE
TX
01
—
751976930005
TRICARE
TX
01
—
8CW707
BCBS
TX
01
—
8CX225
BCBS
TX
01
—
8EZ185
BCBS
TX
01
—
8EZ186
BCBS
TX
Enumeration date
06/12/2008
Last updated
09/11/2015
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