Healthcare Provider Details

I. General information

NPI: 1821114224
Provider Name (Legal Business Name): PERIMETER PRIMARY CARE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 06/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5885 GLENRIDGE DR NE SUITE 200
SANDY SPRINGS GA
30328-5512
US

IV. Provider business mailing address

5885 GLENRIDGE DR NE SUITE 200
SANDY SPRINGS GA
30328-5573
US

V. Phone/Fax

Practice location:
  • Phone: 770-391-0552
  • Fax: 770-395-9344
Mailing address:
  • Phone: 770-391-0552
  • Fax: 770-395-9344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STANLEY JOE BROWN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 770-391-0552