Healthcare Provider Details

I. General information

NPI: 1679069116
Provider Name (Legal Business Name): OCULO-FACIAL CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2018
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 TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number
License Number StateAL

VIII. Authorized Official

Name: DR. MARK S. BROWN
Title or Position: SOLE OWNER
Credential: MD
Phone: 251-650-5437