Brown, Russell E

Brown, Russell E is an sole proprietor health care provider with primary practice located at 4688 Trinity Ct , Marietta GA 30068-1671. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Brown, Russell E can be contacted via phone (404) 316-4992.

Contact Information

Primary practice address
4688 Trinity Ct Marietta GA 30068-1671
Phone: (404) 316-4992
Fax: (770) 973-3587
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 039743 Georgia

Profile Details

NPI number 1194769257
LBN Legal business name Brown, Russell E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 16th, 2006
Last updated Oct 30th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194769257 NPPES
Georgia MEDICAID 00683867B
Georgia Other 13023578
Georgia MEDICAID 055003719A
Georgia Other 15-00149

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