MEDICARE: DRS. BROWDER & ELIJAH, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1013688340
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRS. BROWDER & ELIJAH, P.C.

Provider Business Mailing Address
First Line	:	4421 ATLANTA HWY
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36109
Country	:	US
Telephone Number	:	334-272-2906
Fax Number	:	334-277-7278

Provider Business Practice Location Address
First Line	:	4421 ATLANTA HWY
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36109
Country	:	US
Telephone Number	:	334-272-2906
Fax Number	:	334-277-7278

Authorized Official
Title or Position	:	PRESIDENT/DENTIST
Name	:	DR. LARRY FULTON BROWDER
Credential	:	DMD
Telephone Number	:	334-272-2906

Provider Enumeration Date	:	09/27/2021
Last Update Date	:	09/27/2021

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