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General NPI Number Information
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NPI Number | 1417046517
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Entity Type | Individual
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Provider Name | BRANDI WEAVER WARREN DO
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Gender | Female
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 2484 E PINETREE BLVD
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City | THOMASVILLE
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State | GA
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Zip | 31792-4854
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Country | US
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Telephone | 229-594-6801
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Fax | 229-738-4120
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Provider Business Mailing Address
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Address Line | 2484 E PINETREE BLVD
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City | THOMASVILLE
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State | GA
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Zip | 31792-4854
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Country | US
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Telephone | 229-594-6801
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Fax | 229-738-4120
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2012-01883
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 61681
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License Number State | GA
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