Provider Demographics
NPI:1467678490
Name:BROWN, JAMES LAWTON (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:LAWTON
Last Name:BROWN
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
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Mailing Address - Street 1:9644 OLIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-3002
Mailing Address - Country:US
Mailing Address - Phone:314-993-8111
Mailing Address - Fax:314-993-8796
Practice Address - Street 1:9644 OLIVE BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-3002
Practice Address - Country:US
Practice Address - Phone:314-993-8111
Practice Address - Fax:314-993-8796
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO16731611156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician