Provider Demographics
NPI:1437326014
Name:SAMUEL Y BROWN MD APMC
Entity Type:Organization
Organization Name:SAMUEL Y BROWN MD APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:YOUNG
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:504-443-5437
Mailing Address - Street 1:3813 WILLIAMS BLVD
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-3007
Mailing Address - Country:US
Mailing Address - Phone:504-443-5437
Mailing Address - Fax:504-443-2272
Practice Address - Street 1:3813 WILLIAMS BLVD
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-3007
Practice Address - Country:US
Practice Address - Phone:504-443-5437
Practice Address - Fax:504-443-2272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD03309R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1442437Medicaid