Randall J Brown, M.D.

Individual provider Active NPI Family Medicine Physician · Marysville, KS

NPI 1992725519 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1992725519
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
419667 (KS)
Practice address
1902 May St
Marysville, KS 66508-1200
Phone
(785) 562-3942
Fax
(785) 562-5149
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
419667KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 419667 KS Yes

Addresses

Primary practice location

1902 May St
Marysville, KS 66508-1200

Mailing address

1902 May St
Marysville, KS 66508-1200
Phone (785) 562-3942

Other identifiers

IdentifierTypeStateIssuer
20483OtherNEBC/BS NE
608151OtherKSFIRST GUARD
046810OtherKSBC/BS KS

Other providers in Marysville, KS

All providers in Marysville, KS · Family Medicine Physician in Kansas

Sources for this page

Verify at the official NPI Registry.