Individual
J SCOTT BRICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4279 FOREST LAKE DR W, TIFTON, GA 31794-2352
(229) 848-6058
Mailing address
4279 FOREST LAKE DR W, TIFTON, GA 31794-2352
(229) 848-6058
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
45042
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00885266F
—
GA
Enumeration date
05/30/2005
Last updated
03/25/2008
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