Individual
DR. BRUCE ALLEN BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
055183
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18BDGJN
PTAN
GA
01
—
390605
BLUE CROSS OF GEORGIA
GA
01
—
4309192
CIGNA
—
05
—
504928015A
—
GA
01
—
7716637
AETNA
—
Enumeration date
12/13/2006
Last updated
05/28/2015
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