Provider Demographics
NPI:1457471518
Name:BROWN, LOUIS C (CPO)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:C
Last Name:BROWN
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 NEW BERN AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1214
Mailing Address - Country:US
Mailing Address - Phone:919-231-3132
Mailing Address - Fax:919-231-3132
Practice Address - Street 1:3031 NEW BERN AVE STE 102
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1214
Practice Address - Country:US
Practice Address - Phone:919-231-3132
Practice Address - Fax:919-231-3132
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7795007Medicaid