Individual
MANUEL L BROWN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 NEIGHBORHOOD PL, FAIRDALE, KY 40118-9697
(812) 218-8926
(812) 218-8930
Mailing address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(812) 218-8926
(812) 218-8930
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
16772
KY
207QG0300X
Geriatric Medicine (Family Medicine) Physician
16772
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64167729
—
KY
Enumeration date
02/23/2007
Last updated
05/05/2017
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