Healthcare Provider Details

I. General information

NPI: 1376567826
Provider Name (Legal Business Name): ANNE MARIE MCKENZIE-BROWN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST MOT 7TH FLOOR
ATLANTA GA
30365
US

IV. Provider business mailing address

148 TERRANE RDG
PEACHTREE CITY GA
30269-4014
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-4852
  • Fax:
Mailing address:
  • Phone: 770-487-7790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number031979
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number031979
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: