David Lawrence Brabon, M.D.
Individual provider Active NPI Plastic and Reconstructive Surgery Physician · Mount Vernon, KY
NPI 1235280579 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1235280579
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Plastic and Reconstructive Surgery Physician 2086S0122X
- License
- 17410 (KY)
- Practice address
- 140 Newcomb Ave
Mount Vernon, KY 40456-2728 - Phone
- (606) 256-4148
- NPI assigned
- Jan 15, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17410 | KY | MD | Plastic and Reconstructive Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rockcastle County Hospital, Inc. | Current |
Accepting new patients | |
| Rockcastle Ventures D.B.a. Rockcastle Family Health | Past | Accepting new patients | |
| Rockcastle County Hospital, Inc. | Past | Accepting new patients |
Locations
140 Newcomb Ave
Ste B
Mount Vernon, KY 40456
140 Newcomb Ave
Mount Vernon, KY 40456
Phone (606) 256-3232
145 Newcomb Ave
Mount Vernon, KY 40456
Phone (606) 256-2195
Interoperability endpoints
- rhcdbrabon@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 17410 | KY | Yes |
Addresses
Primary practice location
140 Newcomb Ave
Mount Vernon, KY 40456-2728
Mailing address
PO Box 869
Mount Vernon, KY 40456-0869
Phone (606) 256-4148
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 88178 | Other | CHA | |
| 000000039562 | Other | ANTHEM BC BS | |
| 64174105 | Medicaid | KY | |
| 17410 | Other | KY | MEDICAL LICENSE |
| 240007115 | Other | KY | RAIL ROAD MEDICARE |
| 1300124 | Other | KY | DEPT OF LABOR |
| 61-1350713 | Other | TAX ID |
Other providers in Mount Vernon, KY
- BH Imaging Consulting PLLC
- Ruby Bishop
- Teresa Blair
- Jessica Boggs
- Debora Kaye Bowles
- Lisa Lee Brock
- Tanya M Brock
- Crystal D Brown
- Courtney Parrish Browning
- David Shirley Bullock
All providers in Mount Vernon, KY · Plastic and Reconstructive Surgery Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.