Healthcare Provider Details
I. General information
NPI: 1871556118
Provider Name (Legal Business Name): JAMES ALLEN BROWN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 04/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
159 EXECUTIVE DRIVE ST B
DANVILLE VA
24541
US
IV. Provider business mailing address
159 EXECUTIVE DRIVE ST B
DANVILLE VA
24541
US
V. Phone/Fax
- Phone: 434-792-5964
- Fax: 434-792-5971
- Phone: 434-792-5964
- Fax: 434-792-5971
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 037266 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: