Basic Information
| Provider Information | |||||||||
| NPI: | 1003295551 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | ASHLEY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3600 PRYTANIA ST STE 35 | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701153678 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048978412 | ||||||||
| FaxNumber: | 5042495311 | ||||||||
| Practice Location | |||||||||
| Address1: | 1401 FOUCHER STREET | ||||||||
| Address2: | TOURO INFUSION CENTER | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701153515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048978970 | ||||||||
| FaxNumber: | 5048978777 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2015 | ||||||||
| LastUpdateDate: | 08/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | 323847 | LA | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 390200000X | OK | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 390200000X | LA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
ID Information
| ID | Type | State | Issuer | Description | 2394258 | 05 | LA | MEDICAID |