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NPI 1902914872

NPI 1902914872 : BRENT A FLICKINGER MD : GAINESVILLE, GA

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General NPI Number Information
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    NPI Number           |    1902914872
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    Entity Type          |    Individual 
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    Provider Name        |    BRENT A FLICKINGER MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/29/2006
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    Last Update Date     |    07/14/2025
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Provider Practice Location Address
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    Address Line         |    700 S ENOTA DR NE 
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    City                 |    GAINESVILLE
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    State                |    GA
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    Zip                  |    30501-2403
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    Country              |    US
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    Telephone            |    770-531-3711
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    Fax                  |    770-531-3718
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Provider Business Mailing Address
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    Address Line         |    700 S ENOTA DR NE 
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    City                 |    GAINESVILLE
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    State                |    GA
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    Zip                  |    30501-2403
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    Country              |    US
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    Telephone            |    770-531-3711
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    Fax                  |    770-531-3718
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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        |    207RR0500X
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    Taxonomy Name        |    Rheumatology Physician
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    License Number       |    059065
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    License Number State |    GA
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