Individual
KENNETH A BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1231 RIBAUT RD, BEAUFORT, SC 29902-6147
(843) 525-6622
(843) 522-8243
Mailing address
2295 HENRY TECKLENBERG DR, CHARLESTON, SC 29414-7801
(843) 766-7103
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
13736
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265654511
GROUP BFTENT NPI
SC
01
—
4625215
AETNA KENNETH A BROWN PIN
SC
01
—
7215359
AETNA GROUP PIN
SC
05
—
GP3955
—
SC
01
—
P00135885
RR MEDICARE PIN#
SC
05
—
TL5955
—
SC
Enumeration date
05/31/2005
Last updated
07/06/2017
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