Johnathan Daniel Brown, QBHP

Individual provider Active NPI Case Manager/Care Coordinator · Ash Flat, AR

NPI 1043869019 · NPPES record last updated Dec 7, 2021

Key facts

NPI
1043869019
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
75 Hwy 62/412
Suite J
Ash Flat, AR 72513-9629
Phone
(870) 994-7060
Fax
(870) 994-7063
NPI assigned
Sep 11, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X AR Yes

Addresses

Primary practice location

75 Hwy 62/412
Suite J
Ash Flat, AR 72513-9629

Mailing address

1815 Pleasant Grove Road
Jonesboro, AR 72405-7870
Phone (870) 933-6886

Other identifiers

IdentifierTypeStateIssuer
235720795MedicaidAR

Other providers in Ash Flat, AR

All providers in Ash Flat, AR · Case Manager/Care Coordinator in Arkansas

Sources for this page

Verify at the official NPI Registry.