Basic Information
Provider Information
NPI: 1740495175
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWN
FirstName: STEVE
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 251970
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722251970
CountryCode: US
TelephoneNumber: 5016668676
FaxNumber: 5016606830
Practice Location
Address1: 6601 W 12TH ST
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722041513
CountryCode: US
TelephoneNumber: 5016668686
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/11/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0804XC-6221ARY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry

No ID Information.


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