Provider Demographics
NPI:1306880489
Name:BROWN, JAMES ROGER (OTR/L CHT, CEAS)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ROGER
Last Name:BROWN
Suffix:
Gender:M
Credentials:OTR/L CHT, CEAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1910 N CHURCH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-5632
Mailing Address - Country:US
Mailing Address - Phone:336-274-7480
Mailing Address - Fax:336-274-8903
Practice Address - Street 1:530 SANDHURST DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4426
Practice Address - Country:US
Practice Address - Phone:910-483-9000
Practice Address - Fax:910-483-9302
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1636225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC18961OtherBCBS PROVIDER ID
NC7301894Medicaid
NC18961OtherBCBS PROVIDER ID