MEDICARE: BRENDEN AKINS

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	207P00000X	Emergency Medicine Physician	307973	NY
2	207P00000X	Emergency Medicine Physician	078169	GA

General Provider Information

NPI Number	:	1679991012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDEN AKINS

Provider Business Mailing Address
First Line	:	530 S JACKSON ST
Second Line	:	#C1H17
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1675
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5665 NEW NORTHSIDE DR STE 200
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-4617
Country	:	US
Telephone Number	:	770-874-5400
Fax Number	:

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

Provider Enumeration Date	:	04/02/2014
Last Update Date	:	01/06/2021

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Directions to “ BRENDEN AKINS ” Practice Location

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