Provider Demographics
NPI:1407621840
Name:BROWN, JANIKA DENISE
Entity Type:Individual
Prefix:
First Name:JANIKA
Middle Name:DENISE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3793 MS HIGHWAY 12
Mailing Address - Street 2:
Mailing Address - City:WEIR
Mailing Address - State:MS
Mailing Address - Zip Code:39772-9107
Mailing Address - Country:US
Mailing Address - Phone:662-285-8165
Mailing Address - Fax:
Practice Address - Street 1:3793 MS HIGHWAY 12
Practice Address - Street 2:
Practice Address - City:WEIR
Practice Address - State:MS
Practice Address - Zip Code:39772-9107
Practice Address - Country:US
Practice Address - Phone:662-285-8165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906180207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine