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Individual
DAVID LAWRENCE BRABON
Active
Individual
DAVID LAWRENCE BRABON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
17410
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000039562
ANTHEM BC BS
—
01
—
1300124
DEPT OF LABOR
KY
01
—
17410
MEDICAL LICENSE
KY
01
—
240007115
RAIL ROAD MEDICARE
KY
01
—
61-1350713
TAX ID
—
05
—
64174105
—
KY
01
—
88178
CHA
—
Enumeration date
01/15/2007
Last updated
03/07/2023
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