Provider Demographics
NPI:1255436549
Name:BROWN-BEBOW, VERONA TICE (MD)
Entity type:Individual
Prefix:DR
First Name:VERONA
Middle Name:TICE
Last Name:BROWN-BEBOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4196 HIGHWAY 62 412 STE A
Mailing Address - Street 2:
Mailing Address - City:HARDY
Mailing Address - State:AR
Mailing Address - Zip Code:72542-8002
Mailing Address - Country:US
Mailing Address - Phone:870-856-1202
Mailing Address - Fax:870-856-2107
Practice Address - Street 1:11005 HEBER SPRINGS RD N
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:AR
Practice Address - Zip Code:72523-9561
Practice Address - Country:US
Practice Address - Phone:844-291-4901
Practice Address - Fax:870-895-2164
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC6130207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR102751001Medicaid
AR102751001Medicaid
AR50711Medicare ID - Type Unspecified
AR50711F653Medicare PIN