Healthcare Provider Details
I. General information
NPI: 1124292800
Provider Name (Legal Business Name): BRANDI JOUETT PATRICKSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/15/2008
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
35 COLLIER RD NW SUITE 635
ATLANTA GA
30309-1613
US
IV. Provider business mailing address
2 UNIVERSITY PLZ STE 204
HACKENSACK NJ
07601-6211
US
V. Phone/Fax
- Phone: 404-367-3014
- Fax: 404-351-5983
- Phone: 551-295-8223
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 65446 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 065446 |
| License Number State | GA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 04-50269 |
| License Number State | KS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: