Provider Demographics
NPI:1538252424
Name:BROWN, LAURA S (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:S
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2202 N FORBES BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-1412
Mailing Address - Country:US
Mailing Address - Phone:520-872-7265
Mailing Address - Fax:520-872-7929
Practice Address - Street 1:400 W CAMINO CASA VERDE
Practice Address - Street 2:SUITE 100
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-3564
Practice Address - Country:US
Practice Address - Phone:520-625-1760
Practice Address - Fax:520-648-1394
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ17718207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ277302Medicaid
AZE44416Medicare UPIN
AZ277302Medicaid