Individual
AMANDA ANN BROWN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5798
(504) 896-9827
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD200328
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08837202
—
MS
05
—
1626503
—
LA
Enumeration date
12/22/2005
Last updated
08/14/2019
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