Provider Demographics
NPI:1326082298
Name:BROWN, JAMES T JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:T
Last Name:BROWN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:454 SMITH AVE
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-5535
Mailing Address - Country:US
Mailing Address - Phone:229-227-5510
Mailing Address - Fax:229-227-5527
Practice Address - Street 1:454 SMITH AVE
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792
Practice Address - Country:US
Practice Address - Phone:229-227-5510
Practice Address - Fax:229-227-5527
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAME0085940207P00000X
FLME0085940207Q00000X
GA051025207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000976269BMedicaid
GA000976269NMedicaid
FL265578100Medicaid
GA000976269CMedicaid
GA000976269FMedicaid
GA52177219004OtherBCBS
GA000976269AMedicaid
GA000976269IMedicaid
GA051025OtherGEORGIA LICENSE NUMBER
GA051025OtherGEORGIA LICENSE NUMBER
FL62771ZMedicare PIN
GA511I080433Medicare PIN
GA000976269FMedicaid
GA000976269BMedicaid
GA08BBXGJMedicare PIN
FL080190848Medicare PIN