MEDICARE: DR. STANLEY JOE BROWN M.D.

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
1	207QA0505X	Adult Medicine Physician	37766	GA

General Provider Information

NPI Number	:	1245239698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STANLEY JOE BROWN M.D.

Provider Business Mailing Address
First Line	:	5885 GLENRIDGE DR NE
Second Line	:	SUITE 200
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-5512
Country	:	US
Telephone Number	:	770-391-0552
Fax Number	:	770-395-9344

Provider Business Practice Location Address
First Line	:	5885 GLENRIDGE DR NE
Second Line	:	SUITE 200
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-5512
Country	:	US
Telephone Number	:	770-391-0552
Fax Number	:	770-395-9344

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	06/05/2012

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