Individual
BRETT MAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
855 W BROAD ST STE 1, ATHENS, GA 30601
(706) 850-6134
Mailing address
855 W BROAD ST STE 1, ATHENS, GA 30601-2511
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
83071
GA
207Q00000X
Family Medicine Physician
MD182193
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2015
Last updated
07/24/2019
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