Healthcare Provider Details

I. General information

NPI: 1538402086
Provider Name (Legal Business Name): BRANDEE K ALBERT D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 POINT NORTH PL
DALTON GA
30720-2644
US

IV. Provider business mailing address

302 POINT NORTH PL
DALTON GA
30720-2644
US

V. Phone/Fax

Practice location:
  • Phone: 706-272-4127
  • Fax: 706-279-3969
Mailing address:
  • Phone: 706-272-4127
  • Fax: 706-279-3969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number83493
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: