Brown, Gregory Mark

Brown, Gregory Mark is an individual health care provider with primary practice located at 619 W Dixie Ave , Leesburg FL 34748-2602. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Brown, Gregory Mark can be contacted via phone (352) 314-2424.

Contact Information

Primary practice address
619 W Dixie Ave Leesburg FL 34748-2602
Fax: (352) 314-3010
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME0058899 Florida

Profile Details

NPI number 1386647956
LBN Legal business name Brown, Gregory Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Apr 2nd, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386647956 NPPES
Florida MEDICAID 054017000
Florida Other 12567

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