GARY BROWN; NPI #1396200424

Contact Information

GARY BROWN

302 BROADWAY ST
MARTIN, TN 38237-2455

Phone: 731-587-0600
Fax: 731-587-0600
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Intellectual & Developmental Disabilities	103TM1800X	62	Psychologist, Clinical

Indicates primary specialty

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NPI Profile & details for GARY BROWN

NPI # 1396200424

LBN Legal business name GARY BROWN

Authorized official LISA PAGE - (CREDENTIALING MANAGER)

Entity Organization

Organization subpart ¹ No

Enumeration date 02/02/2019

Last updated 02/02/2019 - About 7 years ago

Identifiers

Medicaid

Q032646

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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GARY BROWN

Contact Information

Specialty

Intellectual & Developmental Disabilities

NPI Profile & details for GARY BROWN

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