Individual
DR. MATTHEW AUSTIN BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9100 13TH RD, MOUNTAIN GROVE, MO 65711-2387
(417) 260-4150
Mailing address
9100 13TH RD, MOUNTAIN GROVE, MO 65711-2387
(417) 260-4150
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2011010536
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174779300
—
MO
05
—
205648306
—
MO
01
—
26D0889777
CLIA
MO
01
—
431560263
TRICARE
MO
01
—
P00985958
RR MCR
MO
Enumeration date
08/07/2008
Last updated
04/20/2024
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