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DR. LORRAINE BROWN D.O.
>> Exclusive Provider Organization >> Managed Care OrganizationsRegistrant NPI Number: 1831293158
Individual Registrant:DR. LORRAINE BROWN D.O.
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
39 W TYLER STREET TALBOTTON, GA 31827 US
Tel: 706-665-2122 Fax: 866-374-9616
Tel: 706-665-2122 Fax: 866-374-9616
Contact information for business:
PO BOX 400 GENEVA, GA 31810-0400 US
Tel: 706-665-2122 Fax: 866-374-9616
Tel: 706-665-2122 Fax: 866-374-9616
Registration Information:
NPI: 1831293158
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 302F00000X | Managed Care Organizations Exclusive Provider Organization | GA | 058152 |
| Y | 207R00000X | Allopathic & Osteopathic Physicians Internal Medicine | GA | 058152 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 116901413 | GA | 05 | |
| UPIN | I62651 | GA | 01 |
