Individual
MR. BRIAN CHRISTOPHER DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
550 PEACHTREE ST NE, DEPT OF EMERGENCY MEDICINE, ATLANTA, GA 30308-2208
(404) 686-3845
Mailing address
275 13TH ST NE APT 603, ATLANTA, GA 30309-3699
(913) 634-0571
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006574
GA
363A00000X
Physician Assistant
085004083
IL
Other
Enumeration date
08/17/2011
Last updated
09/25/2012
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