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General NPI Number Information
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NPI Number | 1518841378
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Entity Type | Individual
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Provider Name | JOHN DUSTIN BROWN PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 1 TRILLIUM WAY
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City | CORBIN
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State | KY
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Zip | 40701-8426
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Country | US
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Telephone | 606-528-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 150 LOCKLIN DR
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City | WILLIAMSBURG
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State | KY
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Zip | 40769-1525
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Country | US
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Telephone | 606-344-3110
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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