Healthcare Provider Details

I. General information

NPI: 1619194842
Provider Name (Legal Business Name): BRIAN STEPHENSON ZEH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 04/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 POPLAR RD SUITE 200
NEWNAN GA
30265-1618
US

IV. Provider business mailing address

2221 PEACHTREE RD NE STE D-647
ATLANTA GA
30309-1148
US

V. Phone/Fax

Practice location:
  • Phone: 404-351-7654
  • Fax: 404-609-7605
Mailing address:
  • Phone: 404-351-7654
  • Fax: 404-609-7605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number64313
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number001010
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number64313
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: