Provider Demographics
NPI:1720163934
Name:BROWN, JAMES MEREDITH (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MEREDITH
Last Name:BROWN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19336 LEITERSBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742
Mailing Address - Country:US
Mailing Address - Phone:717-762-9178
Mailing Address - Fax:717-762-9170
Practice Address - Street 1:632 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268
Practice Address - Country:US
Practice Address - Phone:717-762-9178
Practice Address - Fax:717-762-9170
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE007581T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018624130001Medicaid
61586301OtherCAREFIRST BCBS OF MD
PA427308P3EMedicare ID - Type Unspecified
PA0018624130001Medicaid