Provider Demographics
NPI:1609801067
Name:BROWN, JAMES EDWARD JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWARD
Last Name:BROWN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 54491
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70154-4491
Mailing Address - Country:US
Mailing Address - Phone:504-349-1414
Mailing Address - Fax:504-349-6159
Practice Address - Street 1:1101 MEDICAL CENTER BOULEVARD
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072
Practice Address - Country:US
Practice Address - Phone:504-347-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017650207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1393754Medicaid
LA5L184CE62Medicare PIN
E27683Medicare UPIN
LA1393754Medicaid