Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 384 | NC |
NPI | 1063463982 |
---|---|
Provider Name | Terrill F Brown |
First Address | Fayetteville, NC 28304-3861 |
Second Address | Fayetteville, NC 28304-3861 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0802T | BCBS (01) | NC |
890802T | (05) | NC |
U63850 | (02) | NC |