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Individual

TARA RENEE BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5210 N BELT HWY, SAINT JOSEPH, MO 64506-1211
(816) 271-1330
Mailing address
5210 N BELT HWY, SAINT JOSEPH, MO 64506-1211
(816) 271-4996

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2013021958
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1659697738
MO
05
201074810A
KS
01
P01230394
RR MEDICARE
MO
Enumeration date
04/14/2010
Last updated
11/20/2017
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