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Individual

JASON D BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1801 N SENATE BLVD, STE 755, INDIANAPOLIS, IN 46202-1228
(317) 962-5888
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000787A
IN
363A00000X
Physician Assistant
99017012A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000386766
BCBS
IN
01
066899
SIHO
IN
01
Q0244502
RRMC
IN
Enumeration date
03/23/2006
Last updated
02/15/2022
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