Individual
DOMINIQUE EMMANUEL BROWNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
167 N MAIN ST, TUBA CITY, AZ 86045-0600
(928) 283-2501
(928) 283-2095
Mailing address
PO BOX 600, TUBA CITY, AZ 86045-0600
(928) 283-2501
(928) 283-2095
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
061828814
AZ
363A00000X
Physician Assistant
Primary
7013
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
352969
—
AZ
01
—
TEZ4OH
MEDICARE
AZ
Enumeration date
01/05/2018
Last updated
08/05/2019
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