Individual
DR. KEVIN FRANK BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2812 SILVER CREEK RD, BULLHEAD CITY, AZ 86442-8309
(928) 763-7404
(928) 763-9795
Mailing address
3880 STOCKTON HILL RD, SUITE 103-135, KINGMAN, AZ 86409-0595
(928) 377-9182
(702) 900-9648
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4550
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185299
—
AZ
01
—
AZ4550
LICENSE
AZ
01
—
P00424009
RAILROAD MEDICARE PTAN
AZ
01
—
Z116535
MEDICARE PTAN
AZ
Enumeration date
05/25/2005
Last updated
08/24/2019
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