MEDICARE: DR. KENNETH BROOKS SHERMAN M.D.

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
1	207Q00000X	Family Medicine Physician	E5617	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710972476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH BROOKS SHERMAN M.D.

Provider Business Mailing Address
First Line	:	209 E 2ND ST
Second Line	:
City	:	ELGIN
State	:	TX
Zip	:	78621-2225
Country	:	US
Telephone Number	:	512-285-3315
Fax Number	:

Provider Business Practice Location Address
First Line	:	209 E 2ND ST
Second Line	:
City	:	ELGIN
State	:	TX
Zip	:	78621-2225
Country	:	US
Telephone Number	:	512-285-3315
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	09/27/2010

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Directions to “ DR. KENNETH BROOKS SHERMAN M.D.” Practice Location

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