Healthcare Provider Details

I. General information

NPI: 1215677174
Provider Name (Legal Business Name): BRIANA FORD DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NORTHSIDE FORSYTH DR STE 240
CUMMING GA
30041-6017
US

IV. Provider business mailing address

1400 NORTHSIDE FORSYTH DR STE 240
CUMMING GA
30041-6017
US

V. Phone/Fax

Practice location:
  • Phone: 770-844-0877
  • Fax: 770-844-0891
Mailing address:
  • Phone: 770-844-0877
  • Fax: 770-844-0891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number103604
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: