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General NPI Number Information
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NPI Number | 1386691285
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Entity Type | Organization
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Legal Business Name | FLINT RIVER SURGICAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 04/19/2010
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Provider Practice Location Address
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Address Line | 612 W GORDON ST SUITE B
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City | THOMASTON
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State | GA
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Zip | 30286-3416
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Country | US
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Telephone | 706-647-9433
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Fax | 706-647-9431
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Provider Business Mailing Address
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Address Line | 612 W GORDON ST SUITE B
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City | THOMASTON
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State | GA
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Zip | 30286-3416
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Country | US
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Telephone | 706-647-9433
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Fax | 706-647-9431
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Authorized Official
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Title or Position | PARTNER
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Name | DR. PHILLIP R BROWN
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Credential | MD
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Telephone | 706-647-9433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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