Individual
DR. BENNIE BROWN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
447 N BELAIR RD STE 101, EVANS, GA 30809-3091
(706) 854-2222
(706) 854-2223
Mailing address
PO BOX 1705, AUGUSTA, GA 30903-1705
(706) 774-7263
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
065085
GA
207Q00000X
Family Medicine Physician
18711
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003139672C
—
GA
05
—
08636876
—
MS
Enumeration date
09/30/2005
Last updated
02/05/2015
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