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General NPI Number Information
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NPI Number | 1851482061
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Entity Type | Individual
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Provider Name | HARRIS RADCLIFF BROWN DMD
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Gender | Male
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 03/21/2022
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Provider Practice Location Address
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Address Line | 505 GEORGIAN DR STE A
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City | MOBILE
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State | AL
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Zip | 36609
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Country | US
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Telephone | 251-342-1644
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Fax | 251-342-1648
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Provider Business Mailing Address
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Address Line | 505 GEORGIAN DR STE A
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City | MOBILE
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State | AL
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Zip | 36609
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Country | US
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Telephone | 251-342-1644
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Fax | 251-342-1648
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 3572
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License Number State | AL
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