Provider Demographics
NPI:1477952935
Name:BROWN, KEVIN P (PHARMD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:P
Last Name:BROWN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 HUCKLEBERRY LN
Mailing Address - Street 2:
Mailing Address - City:VILLE PLATTE
Mailing Address - State:LA
Mailing Address - Zip Code:70586-1949
Mailing Address - Country:US
Mailing Address - Phone:337-224-3658
Mailing Address - Fax:318-484-2775
Practice Address - Street 1:1101 4TH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8309
Practice Address - Country:US
Practice Address - Phone:318-484-2773
Practice Address - Fax:318-484-2775
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15510183500000X
TX33300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist