Organization
DANIEL R BROWN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL R BROWN (OWNER)
(618) 988-6034
Entity
Organization
Contact information
Practice address
101 N 16TH ST, HERRIN, IL 62948-1750
(618) 988-6034
(618) 988-6479
Mailing address
101 N 16TH ST, P.O. BOX 2025, HERRIN, IL 62948-1750
(618) 988-6034
(618) 988-6479
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016.004890
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004890
—
IL
Enumeration date
03/11/2008
Last updated
08/18/2008
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