Provider Demographics
NPI:1477506897
Name:BROWN, FRANKIE JAMES (DPM)
Entity Type:Individual
Prefix:DR
First Name:FRANKIE
Middle Name:JAMES
Last Name:BROWN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:FRANK
Other - Middle Name:J
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:69 HIGHBRIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-3341
Mailing Address - Country:US
Mailing Address - Phone:609-714-3766
Mailing Address - Fax:215-226-1404
Practice Address - Street 1:913 W LEHIGH AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-1931
Practice Address - Country:US
Practice Address - Phone:215-226-3891
Practice Address - Fax:215-226-1404
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002698L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000969424 0004Medicaid
PA000109805Medicare PIN
PA000969424 0004Medicaid