Individual
MR. JEFFREY MICHAEL BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
657
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0483PA
—
SC
01
—
195809
MEDCOST
SC
01
—
R397245019
MEDICARE PIN
SC
Enumeration date
04/08/2006
Last updated
12/03/2020
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