Gary Brown

NPI #1396200424 in Martin, Tennessee

Provider Information

NPI Number: 1396200424
Entity Type: Organization
Organization Name: Gary Brown
Primary Specialty: Psychologist - Intellectual & Developmental Disabilities
Enumeration Date: Feb 2, 2019
Last Updated: Feb 2, 2019

Practice Location

Address: 302 BROADWAY ST
City: Martin
State: Tennessee
ZIP Code: 38237-2455
Phone: (731) 587-0600

Authorized Official

Name: LISA KAY PAGE
Title: CREDENTIALING MANAGER
Phone: (731) 693-3465

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Intellectual & Developmental Disabilities — Intellectual & Developmental Disabilities	103TM1800X	Primary

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