Provider Demographics
NPI:1861444747
Name:MONTAGUE-BROWN, KARLA PATRICE (MD)
Entity Type:Individual
Prefix:DR
First Name:KARLA
Middle Name:PATRICE
Last Name:MONTAGUE-BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 BERWICK TRL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-4902
Mailing Address - Country:US
Mailing Address - Phone:615-612-3075
Mailing Address - Fax:615-612-3075
Practice Address - Street 1:901 12TH AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-4705
Practice Address - Country:US
Practice Address - Phone:615-254-1786
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN018350207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3042308Medicaid
TNE50352Medicare UPIN
TN3042304Medicare ID - Type Unspecified