Individual
DAVID LAWRENCE BRABON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
140 NEWCOMB AVE, MOUNT VERNON, KY 40456-2728
(606) 256-4148
Mailing address
PO BOX 869, MOUNT VERNON, KY 40456-0869
(606) 256-4148
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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