Provider Demographics
NPI:1245238773
Name:BROWN, JAMES EDWARD SR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:BROWN
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2200 JAY ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-4306
Mailing Address - Country:US
Mailing Address - Phone:504-583-6459
Mailing Address - Fax:504-889-6351
Practice Address - Street 1:4720 I-10 SERVICE RD.
Practice Address - Street 2:SUITE 309
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001
Practice Address - Country:US
Practice Address - Phone:504-889-6350
Practice Address - Fax:504-889-6351
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08887208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1096393Medicaid
LA439507390OtherBLUE CROSS ID
LA2001683OtherAETNA ID
LA020010960OtherRAILROAD MEDICARE ID
LA50380Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
LA1096393Medicaid