Provider Demographics
NPI:1225297658
Name:DAVID J. BROWN, M.D. APMC
Entity Type:Organization
Organization Name:DAVID J. BROWN, M.D. APMC
Other - Org Name:DERIDDER SUGICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-463-8556
Mailing Address - Street 1:302 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:DERIDDER
Mailing Address - State:LA
Mailing Address - Zip Code:70634-4902
Mailing Address - Country:US
Mailing Address - Phone:337-463-8556
Mailing Address - Fax:337-463-8561
Practice Address - Street 1:302 W 6TH ST
Practice Address - Street 2:
Practice Address - City:DERIDDER
Practice Address - State:LA
Practice Address - Zip Code:70634-4902
Practice Address - Country:US
Practice Address - Phone:337-463-8556
Practice Address - Fax:337-463-8561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA019016174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1929620Medicaid
LA1929620Medicaid
LAF28553Medicare UPIN