Provider Demographics
NPI:1144222019
Name:BROWN, STEVEN PAUL (DC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:PAUL
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1772 E BOSTON ST STE 107
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-6243
Mailing Address - Country:US
Mailing Address - Phone:480-377-1226
Mailing Address - Fax:480-377-1228
Practice Address - Street 1:1772 E BOSTON ST STE 107
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-6243
Practice Address - Country:US
Practice Address - Phone:480-377-1226
Practice Address - Fax:480-377-1228
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5419111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU58853Medicare UPIN
AZZ69687Medicare ID - Type Unspecified
AZU69686Medicare ID - Type Unspecified