Provider Demographics
NPI:1871592451
Name:BROWN, ROBERT STICKLER (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STICKLER
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5901 WESTOWN PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:W DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8218
Mailing Address - Country:US
Mailing Address - Phone:515-225-3546
Mailing Address - Fax:515-224-5946
Practice Address - Street 1:5901 WESTOWN PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:W DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8218
Practice Address - Country:US
Practice Address - Phone:515-225-3546
Practice Address - Fax:515-224-5946
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA17977207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1066217Medicaid
IA44434OtherBLUE CROSS BLUE SHIELD
IA44434OtherBLUE CROSS BLUE SHIELD
IA44434Medicare ID - Type UnspecifiedMEDICARE