Individual
DR. DARRELL LAWRENCE BRAUTIGAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
7175 JONESBORO RD, MORROW, GA 30260-2943
(770) 961-2020
(770) 968-0854
Mailing address
5848 HOWELL HIGHLANDS PL, STONE MOUNTAIN, GA 30087-1843
(770) 921-8333
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
683T
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55000122A
—
GA
Enumeration date
08/11/2005
Last updated
05/18/2009
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