Individual
DR. CLARENCE W. BROWN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
036096380
IL
207N00000X
Dermatology Physician
Primary
2024
WI
207N00000X
Dermatology Physician
4301093918
MI
207NS0135X
Procedural Dermatology Physician
036096380
IL
207NS0135X
Procedural Dermatology Physician
4301093918
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360963803
—
IL
05
—
1386654390
—
MI
01
—
911779986
TAX ID
IL
Enumeration date
08/09/2006
Last updated
07/05/2022
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