Provider Demographics
NPI:1285833475
Name:TAMMY L. BROWN, M.D., P.S.C.
Entity Type:Organization
Organization Name:TAMMY L. BROWN, M.D., P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-387-4251
Mailing Address - Street 1:606 BURKESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:KY
Mailing Address - Zip Code:42602-1612
Mailing Address - Country:US
Mailing Address - Phone:606-387-4251
Mailing Address - Fax:606-387-0803
Practice Address - Street 1:606 BURKESVILLE RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:KY
Practice Address - Zip Code:42602-1612
Practice Address - Country:US
Practice Address - Phone:606-387-4251
Practice Address - Fax:606-387-0803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY27409207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65934531Medicaid
KY65934531Medicaid
KY6201Medicare PIN