Provider Demographics
NPI:1619092061
Name:BRAUWN, EDWARD AUGUST (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:AUGUST
Last Name:BRAUWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7336 HWY 1 SOUTH
Mailing Address - Street 2:
Mailing Address - City:DONALDSONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70346
Mailing Address - Country:US
Mailing Address - Phone:225-473-3186
Mailing Address - Fax:225-473-3188
Practice Address - Street 1:7336 HWY 1 SOUTH
Practice Address - Street 2:
Practice Address - City:DONALDSONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70346
Practice Address - Country:US
Practice Address - Phone:225-473-3186
Practice Address - Fax:225-473-3188
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA331111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
20174OtherBCBS
20174OtherBCBS