Provider Demographics
NPI:1770644957
Name:BROWN, JAMES WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILLIAM
Last Name:BROWN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1180 WEST GRANADA BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174
Mailing Address - Country:US
Mailing Address - Phone:386-677-2606
Mailing Address - Fax:386-672-5341
Practice Address - Street 1:1180 WEST GRANADA BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174
Practice Address - Country:US
Practice Address - Phone:386-677-2606
Practice Address - Fax:386-672-5341
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2010-02-26
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Provider Licenses
StateLicense IDTaxonomies
FLME81173207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DTH000Medicare UPIN