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NPI Code Detail

MEDICARE: DR. BRIAN FELIPE JIMENEZ MD

MEDICARE: DR. BRIAN FELIPE JIMENEZ MD
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
12086S0102XSurgical Critical Care Physician1538747438GA
22086S0127XTrauma Surgery Physician1538747738GA
3390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1538747738
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN FELIPE JIMENEZ MD
Provider Business Mailing Address
First Line : 1364 CLIFTON RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30322-1059
Country : US
Telephone Number : 816-529-8112
Fax Number :
Provider Business Practice Location Address
First Line : 677 CHURCH ST NE
Second Line :
City : MARIETTA
State : GA
Zip : 30060-1101
Country : US
Telephone Number : 816-529-8112
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2021
Last Update Date : 04/06/2026

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