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:
Health care specialties
| Specialty | Code | License # | 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 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194769257 | NPPES |
| Georgia | MEDICAID | 00683867B | |
| Georgia | Other | 13023578 | |
| Georgia | MEDICAID | 055003719A | |
| Georgia | Other | 15-00149 |
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