Organization
TIMOTHY R BROWN MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARTHA SUNDERMAN (MANAGER/BILLER)
(719) 275-4061
Entity
Organization
Contact information
Practice address
1335 PHAY AVE STE D, CANON CITY, CO 81212-2349
(719) 275-4061
(719) 275-4058
Mailing address
1335 PHAY AVE STE D, CANON CITY, CO 81212-2349
(171) 927-5406
(719) 275-4058
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C028896
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06575749
—
CO
Enumeration date
07/12/2007
Last updated
07/21/2021
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