Organization
DPM BRISSETT NRGA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT P BRISSETT DPM (DPM)
(646) 721-2072
Entity
Organization
Contact information
Practice address
5124 GROVE FIELD PT, LITHONIA, GA 30038-2387
(646) 721-2072
(866) 678-9749
Mailing address
5124 GROVE FIELD PT, LITHONIA, GA 30038-2387
(646) 721-2072
(866) 678-9749
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD000950
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48SCIQW
MEDICARE
GA
Enumeration date
08/11/2005
Last updated
08/22/2020
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