Individual
JASON EDWARD BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 W MAIN ST, RIVERTON, WY 82501-3230
(307) 856-6530
Mailing address
1001 W MAIN ST, RIVERTON, WY 82501-3230
(307) 856-6530
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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