Individual
EDWIN THOMAS BROTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2204 LEXINGTON AVENUE, ASHLAND, KY 41101
(513) 300-0149
Mailing address
2208 SOUTH RD, CINCINNATI, OH 45233-4267
(513) 300-0149
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
31144
KY
207L00000X
Anesthesiology Physician
62695
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000351385
ANTHEM BLUE SHIELD
—
01
—
000000388319
ANTHEM BLUE SHIELD
—
05
—
0950047
—
OH
01
—
173664
PRIVATE HEALTH CARE
—
05
—
200366710
—
IN
01
—
5087130
AETNA
—
05
—
64311442
—
KY
Enumeration date
10/27/2005
Last updated
01/26/2011
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