Provider Demographics
NPI:1336231489
Name:BROWN, JAMES SAMUEL III (M D)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:SAMUEL
Last Name:BROWN
Suffix:III
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 WALKER WAY
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-6607
Mailing Address - Country:US
Mailing Address - Phone:662-320-6555
Mailing Address - Fax:662-320-6566
Practice Address - Street 1:100 WALKER WAY
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-6607
Practice Address - Country:US
Practice Address - Phone:662-320-6555
Practice Address - Fax:662-320-6566
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS16037207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00126317Medicaid
MSG78406Medicare UPIN