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NPI Code Detail

MEDICARE: KYLE DANIEL BROWN PA-C

MEDICARE: KYLE DANIEL BROWN PA-C
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
1363A00000XPhysician Assistant0010-02413NC

General Provider Information

NPI Number : 1518292952
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE DANIEL BROWN PA-C
Provider Business Mailing Address
First Line : PO BOX 744786
Second Line :
City : ATLANTA
State : GA
Zip : 30374-4786
Country : US
Telephone Number : 704-834-2450
Fax Number : 704-671-5331
Provider Business Practice Location Address
First Line : 700 N MAIN ST
Second Line :
City : STANLEY
State : NC
Zip : 28164-1438
Country : US
Telephone Number : 704-263-8945
Fax Number : 704-263-2591
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2009
Last Update Date : 11/30/2022

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