Individual
DR. ROBERT JUDSON BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
220 S PARK AVE, 3RD FLOOR, HERRIN, IL 62948-3612
(618) 942-2002
(618) 351-6497
Mailing address
PO BOX 1105, INDIANAPOLIS, IN 46206-1105
(618) 549-5361
(618) 549-5128
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036117928
IL
208600000X
Surgery Physician
23499
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036117928
—
IL
01
—
133018
HEALTH ALLIANCE
IL
01
—
319226
GHP
IL
01
—
3932056
BCBS
IL
05
—
64234990
—
KY
01
—
654532
HEALTHLINK
IL
01
—
7210895
AETNA
IL
Enumeration date
06/09/2005
Last updated
01/12/2015
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