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General NPI Number Information
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NPI Number | 1639309065
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Entity Type | Organization
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Legal Business Name | BROWN FAMILY MEDICINE, LLC
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Dates
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Enumeration Date | 07/20/2009
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Last Update Date | 07/20/2009
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Provider Practice Location Address
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Address Line | 20 RIVERBEND DR SW
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City | ROME
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State | GA
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Zip | 30161-6066
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Country | US
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Telephone | 706-291-1270
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Fax | 706-291-1276
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Provider Business Mailing Address
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Address Line | 20 RIVERBEND DR SW
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City | ROME
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State | GA
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Zip | 30161-6066
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Country | US
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Telephone | 706-291-1270
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Fax | 706-291-1276
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | AMY CUZZORT
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Credential |
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Telephone | 706-290-8115
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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 | 036109
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License Number State | GA
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