Provider Demographics
NPI:1245315779
Name:BROWN, CARL LESTER JR (PA-C)
Entity type:Individual
Prefix:MR
First Name:CARL
Middle Name:LESTER
Last Name:BROWN
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:3224 LINDEN DR.
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502
Mailing Address - Country:US
Mailing Address - Phone:907-243-0598
Mailing Address - Fax:907-243-0597
Practice Address - Street 1:300 WEST DIMOND BLVD.
Practice Address - Street 2:SUITE 12
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515
Practice Address - Country:US
Practice Address - Phone:907-341-7757
Practice Address - Fax:907-341-7760
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2012-08-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK0473363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical