Provider Demographics
NPI:1932542198
Name:BROWN, FALON VICTORIA (DO)
Entity Type:Individual
Prefix:DR
First Name:FALON
Middle Name:VICTORIA
Last Name:BROWN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454-2532
Mailing Address - Country:US
Mailing Address - Phone:985-370-7546
Mailing Address - Fax:985-370-7765
Practice Address - Street 1:180 N 5TH ST
Practice Address - Street 2:
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454-2532
Practice Address - Country:US
Practice Address - Phone:985-370-7546
Practice Address - Fax:985-370-7765
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-01220207R00000X
LADO.000443207R00000X
LADO000443207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1443301Medicaid