Provider Demographics
NPI:1760970487
Name:BROWN, KENNETH BRADBURY JR (MD)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:BRADBURY
Last Name:BROWN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N2198 UNC HOSPITALS CB# 7010
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7010
Mailing Address - Country:US
Mailing Address - Phone:919-966-5136
Mailing Address - Fax:984-974-4873
Practice Address - Street 1:N2198 UNC HOSPITALS CB# 7010
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7010
Practice Address - Country:US
Practice Address - Phone:919-966-5136
Practice Address - Fax:984-974-4873
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC238352390200000X
NC2023-01341207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program