Provider Demographics
NPI:1013688340
Name:DRS. BROWDER & ELIJAH, P.C.
Entity Type:Organization
Organization Name:DRS. BROWDER & ELIJAH, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:FULTON
Authorized Official - Last Name:BROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:334-272-2906
Mailing Address - Street 1:4421 ATLANTA HWY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109
Mailing Address - Country:US
Mailing Address - Phone:334-272-2906
Mailing Address - Fax:334-277-7278
Practice Address - Street 1:4421 ATLANTA HWY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109
Practice Address - Country:US
Practice Address - Phone:334-272-2906
Practice Address - Fax:334-277-7278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty