Provider Demographics
NPI:1427543073
Name:BROWN JR., RUDOLPH THOMAS JR (BS)
Entity Type:Individual
Prefix:MR
First Name:RUDOLPH
Middle Name:THOMAS
Last Name:BROWN JR.
Suffix:JR
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3308 TULANE AVE STE 407
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-7158
Mailing Address - Country:US
Mailing Address - Phone:504-821-6830
Mailing Address - Fax:
Practice Address - Street 1:615 BARONNE ST STE 305
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70113-1018
Practice Address - Country:US
Practice Address - Phone:504-814-8001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-26
Last Update Date:2018-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker