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NPI Code Detail

MEDICARE: DR. HENRY HOWARD BREWER III OD

MEDICARE: DR. HENRY HOWARD BREWER III OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOPT002187GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194702225
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HENRY HOWARD BREWER III OD
Provider Business Mailing Address
First Line : 8614 WESTWOOD CENTER DR FL 9
Second Line :
City : VIENNA
State : VA
Zip : 22182-3970
Country : US
Telephone Number : 703-847-8899
Fax Number :
Provider Business Practice Location Address
First Line : 15196 US HIGHWAY 19 S
Second Line :
City : THOMASVILLE
State : GA
Zip : 31757-4820
Country : US
Telephone Number : 229-228-4770
Fax Number : 229-225-9060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2005
Last Update Date : 09/09/2025

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