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Individual

MRS. MADISON AVARA BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3109 BIENVILLE BLVD, OCEAN SPRINGS, MS 39564-4361
(228) 875-3778
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
(228) 497-7576
(228) 497-8869

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00287
MS
363A00000X
Physician Assistant
PA1161
AL
363AM0700X
Medical Physician Assistant
PA00287
MS
363AM0700X
Medical Physician Assistant
PA1161
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02227801
MS
Enumeration date
04/25/2016
Last updated
05/02/2022
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