Individual
HAROLD MORDECAI BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2003 W 4TH ST, ONTARIO, OH 44906-1865
(567) 307-7860
(567) 307-7861
Mailing address
700 N COLUMBUS ST, CRESTLINE, OH 44827-1455
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34005482
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000012001
ANTHEM
OH
01
—
080079622
RAILROAD MEDICARE
OH
05
—
0882522
—
OH
Enumeration date
06/13/2005
Last updated
12/07/2020
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