Healthcare Provider Details

I. General information

NPI: 1114999729
Provider Name (Legal Business Name): MARK SCOTT BROWN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 10/24/2023
Certification Date: 10/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6576 AIRPORT BLVD STE B200
MOBILE AL
36608-3788
US

IV. Provider business mailing address

6576 AIRPORT BLVD STE B200
MOBILE AL
36608-3788
US

V. Phone/Fax

Practice location:
  • Phone: 251-650-5437
  • Fax: 800-689-2131
Mailing address:
  • Phone: 251-650-5437
  • Fax: 800-689-2131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME68947
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number198405-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number17168
License Number StateMS
# 4
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number21881
License Number StateAL
# 5
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number21881
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: