MEDICARE: THE BRASELTON CLINIC

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	207R00000X	Internal Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	511G700042	OTHER	GA	MEDICARE GROUP ID

General Provider Information

NPI Number	:	1972796803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE BRASELTON CLINIC

Provider Business Mailing Address
First Line	:	601 S ENOTA DR NE
Second Line	:	SUITE Q
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-2400
Country	:	US
Telephone Number	:	770-533-8400
Fax Number	:	770-533-8409

Provider Business Practice Location Address
First Line	:	5875 THOMPSON MILL RD
Second Line	:	STE. 200
City	:	HOSCHTON
State	:	GA
Zip	:	30548-4001
Country	:	US
Telephone Number	:	770-965-2022
Fax Number	:	770-967-6325

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MARK KLEIN
Credential	:
Telephone Number	:	770-533-8406

Provider Enumeration Date	:	08/23/2007
Last Update Date	:	11/24/2008

Similar Medicare Providers

1093725327 — NORTHEAST GEORGIA ORTHOPAEDICS & SPORTS MEDICINE, LLC
Practice Location Address:

5737 THOMPSON MILL RD
HOSCHTON, GA
30548-4001

Practice Phone: 770-532-7092
Practice Fax: 770-536-0383

1154516060 — SARAH LYNN CORNETT PT
Practice Location Address:

5415 THOMPSON MILL RD
HOSCHTON, GA
30548-4038

Practice Phone: 770-965-3508
Practice Fax: 770-965-3278

1609846914 — SARAH ADDISON LPC
Practice Location Address:

5415 THOMPSON MILL RD
HOSCHTON, GA
30548-4132

Practice Phone: 678-231-5557
Practice Fax: 706-850-0899

1194763292 — DR. DELORES ANN COMBSBARNES D.P.M.
Practice Location Address:

4704 CHATEAU FOREST WAY
HOSCHTON, GA
30548-6232

Practice Phone: 678-859-8902
Practice Fax: 770-307-1443

1295773802 — GEORGIA FOOT CARE, INC.
Practice Location Address:

4704 CHATEAU FOREST WAY
HOSCHTON, GA
30548-6232

Practice Phone: 770-307-1094
Practice Fax: 770-307-1443

1235140773 — DR. JENNIFER HAWK WILEY DC
Practice Location Address:

117 BELL AVENUE
HOSCHTON, GA
30548

Practice Phone: 706-654-2155
Practice Fax: 706-654-2171

Directions to “THE BRASELTON CLINIC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.