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NPI Code Detail

MEDICARE: BEAUFORT ENT & ALLERGY LLC

MEDICARE: BEAUFORT ENT & ALLERGY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist003200SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17215359OTHERSCAETNA GROUP PIN
27326369OTHERSCAETNA DON R CHRISTIAN PIN
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
54625215OTHERSCAETNA KENNETH A BROWN PIN
61518130095OTHERSCTRACY BRANDE M.S. NPI
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
81467455949OTHERSCDON CHRISTIAN NPI
91699778076OTHERSCKENNETH BROWNS NPI

General Provider Information

NPI Number : 1265654511
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEAUFORT ENT & ALLERGY LLC
Provider Business Mailing Address
First Line : 1231 RIBAUT RD
Second Line :
City : BEAUFORT
State : SC
Zip : 29902-6147
Country : US
Telephone Number : 843-525-6622
Fax Number :
Provider Business Practice Location Address
First Line : 1231 RIBAUT RD
Second Line :
City : BEAUFORT
State : SC
Zip : 29902-6147
Country : US
Telephone Number : 843-525-6622
Fax Number :
Authorized Official
Title or Position : PART OWNER
Name : DR. KENNETH A BROWN
Credential : M.D.
Telephone Number : 843-525-6622
Provider Enumeration Date : 05/03/2007
Last Update Date : 06/10/2014

Similar Medicare Providers

1467455949 — DON R CHRISTIAN JR. MD
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1104464981 — DR. NICHOLAS B DRURY MD
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1144177718 — KATHERINE FOOT OTR/L, CLT
Practice Location Address:
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Directions to “BEAUFORT ENT & ALLERGY LLC ” Practice Location

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