Individual
MARY G BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
740 S LIMESTONE STE B101, LEXINGTON, KY 40536-6514
(859) 323-5661
(859) 323-6411
Mailing address
1431 CENTERPOINT BLVD, SUITE 100, KNOXVILLE, TN 37932-1984
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA642
KY
363AM0700X
Medical Physician Assistant
PA642
KY
363AS0400X
Surgical Physician Assistant
PA642
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95002408
—
KY
Enumeration date
06/29/2006
Last updated
04/29/2024
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