Provider Demographics
NPI:1699862839
Name:KERRY M. BROWN, M.D. APMC
Entity type:Organization
Organization Name:KERRY M. BROWN, M.D. APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-893-4452
Mailing Address - Street 1:204 N. MAGDALEN SQUARE
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510-7645
Mailing Address - Country:US
Mailing Address - Phone:337-893-4452
Mailing Address - Fax:337-893-7870
Practice Address - Street 1:204 N MAGDALEN SQ
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-4645
Practice Address - Country:US
Practice Address - Phone:337-289-8972
Practice Address - Fax:337-289-8970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16581207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA436726940AOtherBLUE CROSS
LA1331210Medicaid
LAB64257Medicare UPIN
LADD6221Medicare PIN
LA1331210Medicaid