Healthcare Provider Details

I. General information

NPI: 1588773337
Provider Name (Legal Business Name): BROWN FOOT CARE CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 01/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 PICKENS ST
EUTAW AL
35462-1123
US

IV. Provider business mailing address

204 PICKENS ST
EUTAW AL
35462-1123
US

V. Phone/Fax

Practice location:
  • Phone: 205-372-0708
  • Fax: 205-372-0720
Mailing address:
  • Phone: 205-372-0708
  • Fax: 205-372-0720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00187
License Number StateAL

VIII. Authorized Official

Name: DR. JEFFREY ALLAN BROWN
Title or Position: PRESIDENT
Credential: DPM
Phone: 205-372-0708