Organization
TIMOTHY A BROWN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY ALDEN BROWN MD (PRESIDENT)
(304) 723-3090
Entity
Organization
Contact information
Practice address
2619 PENNSYLVANIA AVE STE 2, WEIRTON, WV 26062
(304) 723-3090
(304) 723-2576
Mailing address
2619 PENNSYLVANIA AVE STE 2, WEIRTON, WV 26062-3777
(304) 723-3090
(304) 723-2576
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
10935
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001941456
MOUNTAIN STATE BC BS
WV
05
—
3810009580
—
WV
01
—
DG2133
RAILROAD MEDICARE
WV
01
—
TI9369721
MEDICARE PTAN
WV
Enumeration date
10/31/2005
Last updated
07/22/2019
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