MEDICARE: PRECIOUS L. BRASWELL, MD, OB/GYN, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1639255045
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECIOUS L. BRASWELL, MD, OB/GYN, LLC

Provider Business Mailing Address
First Line	:	2885 HEADLAND DR
Second Line	:
City	:	EAST POINT
State	:	GA
Zip	:	30344-6652
Country	:	US
Telephone Number	:	404-344-9333
Fax Number	:	404-344-9922

Provider Business Practice Location Address
First Line	:	2885 HEADLAND DR
Second Line	:
City	:	EAST POINT
State	:	GA
Zip	:	30344-6652
Country	:	US
Telephone Number	:	404-344-9333
Fax Number	:	404-344-9922

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. PRECIOUS L BRASWELL
Credential	:
Telephone Number	:	404-344-9333

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	10/21/2020

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