Individual
DR. RONNIE L BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
915 W MAIN ST STE 100, ABINGDON, VA 24210-2481
(276) 628-9507
(276) 628-9439
Mailing address
PO BOX 2045, ABINGDON, VA 24212-2045
(276) 628-9507
(276) 628-9439
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401003814
VA
1223G0001X
General Practice Dentistry
0401003814
VA
332B00000X
Durable Medical Equipment & Medical Supplies
0401003814
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
088818
ANTHEM
VA
01
—
1375044
UNITED CONCORDIA
—
05
—
9181262
—
VA
Enumeration date
01/09/2007
Last updated
07/08/2019
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