Provider Demographics
NPI:1417048653
Name:BROWN-JACKSON, ERICA M (MD)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:M
Last Name:BROWN-JACKSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PONY LN
Mailing Address - Street 2:
Mailing Address - City:SAINT ROSE
Mailing Address - State:LA
Mailing Address - Zip Code:70087-3638
Mailing Address - Country:US
Mailing Address - Phone:504-717-5454
Mailing Address - Fax:
Practice Address - Street 1:401 VETERANS BLVD
Practice Address - Street 2:SUITE 205A
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-2957
Practice Address - Country:US
Practice Address - Phone:504-837-5200
Practice Address - Fax:504-837-5260
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200224207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine