Individual
NATHAN RIAS BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., D.M.D.
Contact information
Practice address
1271 7TH ST, SLIDELL, LA 70458
(985) 643-1010
Mailing address
1271 7TH ST, NORTHLAKE ORAL AND FACIAL SURGERY LLC, SLIDELL, LA 70458
(985) 643-1010
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
MD.28043
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01586093
—
MS
01
—
051117632
BCBS
AL
01
—
051117634
BCBS
AL
01
—
051117635
BCBS
AL
01
—
051117856
BCBS
AL
01
—
051118675
BCBS
AL
05
—
129132
—
AL
05
—
129133
—
AL
05
—
129134
—
AL
05
—
129135
—
AL
05
—
129136
—
AL
01
—
Z21003
VIVA
AL
Enumeration date
12/30/2008
Last updated
07/20/2012
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