Individual
JASON EDWARD BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01063733A
IN
2085R0202X
Diagnostic Radiology Physician
Primary
8042A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200868510
—
IN
01
—
P00459733
RR MEDICARE
IN
Enumeration date
06/27/2007
Last updated
09/29/2016
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