Individual
RUSSELL E BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4688 TRINITY CT, MARIETTA, GA 30068-1671
(404) 316-4992
(770) 973-3587
Mailing address
4688 TRINITY CT, MARIETTA, GA 30068-1671
(404) 316-4992
(770) 973-3587
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
039743
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00683867B
—
GA
05
—
055003719A
—
GA
01
—
13023578
RR MEDICARE
GA
01
—
15-00149
EVERCARE
GA
Enumeration date
06/16/2006
Last updated
10/30/2013
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