Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 6416 | AL |
NPI | 1013418201 |
---|---|
Provider Name | Dr. Clark Clayton Browne JR. |
First Address | Vestavia Hills, AL 35216-2201 |
Second Address | Decatur, AL 35601-5015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2018 |
Last Update Date | 23/02/2018 |