Provider Demographics
NPI:1861097834
Name:BROWN, DONALD ARTHUR
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:ARTHUR
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 HORTON SISTERS RD
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:OH
Mailing Address - Zip Code:45656-9760
Mailing Address - Country:US
Mailing Address - Phone:740-978-0864
Mailing Address - Fax:
Practice Address - Street 1:353 E MAIN ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-1758
Practice Address - Country:US
Practice Address - Phone:740-286-3562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03209718183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist