Individual
DR. BONNIE SUSANNE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11969 S DIXIE HWY, SONORA, KY 42776-9739
(270) 369-9706
(270) 369-9263
Mailing address
PO BOX 2309, ELIZABETHTOWN, KY 42702-2309
(270) 706-1023
(270) 706-1167
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33782
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000202961
BC/BS PIN
KY
01
—
080172384
MCR RAILROAD
KY
01
—
1133127
PSPT
KY
01
—
2437780000
PASSPORT ADVANTAGE MCR
KY
05
—
64337827
—
KY
Enumeration date
05/10/2006
Last updated
06/27/2008
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