Provider Demographics
NPI:1043483720
Name:JAMES L. BROWN, JR., M.D., P.C.
Entity type:Organization
Organization Name:JAMES L. BROWN, JR., M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:706-548-3478
Mailing Address - Street 1:2090 PRINCE AVE
Mailing Address - Street 2:BUILDING A
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-6047
Mailing Address - Country:US
Mailing Address - Phone:706-548-3478
Mailing Address - Fax:706-543-7861
Practice Address - Street 1:2090 PRINCE AVE
Practice Address - Street 2:BUILDING A
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-6047
Practice Address - Country:US
Practice Address - Phone:706-548-3478
Practice Address - Fax:706-543-7861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD44945Medicare UPIN
GAGRP2980Medicare PIN