Individual
DR. JOEL I BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
622 W NORTH ST, GRANGEVILLE, ID 83530-1240
(208) 983-0260
(208) 983-0047
Mailing address
622 W NORTH ST, GRANGEVILLE, ID 83530-1240
(208) 983-0260
(208) 983-0047
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0-869
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010015436
REGENCE
ID
01
—
0620530001
MEDICARE DME
ID
Enumeration date
09/12/2005
Last updated
02/13/2008
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