Individual
MR. BRENTLY T MADARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
3824 S HIGHWAY 27, LA FAYETTE, GA 30728-3967
(706) 639-9055
(706) 639-9057
Mailing address
4300 N POINT PKWY STE 300, ALPHARETTA, GA 30022-4102
(770) 442-1911
(770) 442-0306
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
APN0000006974
TN
363LF0000X
Family Nurse Practitioner
Primary
RN097785
GA
Other
Enumeration date
11/09/2006
Last updated
02/18/2026
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