Healthcare Provider Details

I. General information

NPI: 1790281723
Provider Name (Legal Business Name): BRIANNA MILLSAPS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2018
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DOCTORS PARK
CAIRO GA
39828-3072
US

IV. Provider business mailing address

1756 LOWER HAWTHORNE TRL
CAIRO GA
39828-6212
US

V. Phone/Fax

Practice location:
  • Phone: 229-378-8110
  • Fax:
Mailing address:
  • Phone: 850-688-3892
  • Fax: 833-941-2626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number89124
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME150760
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: