Provider Demographics
NPI:1841496718
Name:SIMON-DAVIS, BRANDON DEANN (MD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:DEANN
Last Name:SIMON-DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRANDEE
Other - Middle Name:DEANN
Other - Last Name:SIMON-DAVIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1415 TULANE AVE
Mailing Address - Street 2:TW-4
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:130 LAKEVIEW CIRCLE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433
Practice Address - Country:US
Practice Address - Phone:985-892-6858
Practice Address - Fax:985-892-6965
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.203848207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine