Provider Demographics
NPI:1730159807
Name:BROWN, JAMES MILTON III (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MILTON
Last Name:BROWN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 NELSON RD
Mailing Address - Street 2:BLDG. C, STE. 11
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-4148
Mailing Address - Country:US
Mailing Address - Phone:337-474-0222
Mailing Address - Fax:337-477-0277
Practice Address - Street 1:4150 NELSON RD
Practice Address - Street 2:BLDG. C, STE. 11
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-4148
Practice Address - Country:US
Practice Address - Phone:337-474-0222
Practice Address - Fax:337-477-0277
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09990R207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1679551Medicaid
LAG26855Medicare UPIN
LA5W802C423Medicare ID - Type Unspecified