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Individual

MR. JUSTIN FORD BREWER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1720 SPRING HILL AVE STE 3, MOBILE, AL 36604-1410
(251) 435-2663
(251) 435-1098
Mailing address
1720 SPRING HILL AVE STE 3, MOBILE, AL 36604-1410
(251) 435-2663
(251) 435-1098

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA551
AL
363AS0400X
Surgical Physician Assistant
PA551
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
631174582
TAX ID
AL
Enumeration date
08/07/2007
Last updated
01/11/2024
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