Individual
STEPHEN L BROTHERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1651 W ROSEDALE, SUITE 200, FORT WORTH, TX 76104-7437
(817) 335-4316
(817) 336-2504
Mailing address
PO BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 332-4465
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G3184
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120310105
—
TX
01
—
200045844
RAILROAD MEDICARE
TX
Enumeration date
07/17/2006
Last updated
09/30/2011
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