Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 041740 | GA |
NPI | 1003805342 |
---|---|
Provider Name | Dr. Dorland Brown |
First Address | Kennesaw, GA 30144-2085 |
Second Address | Kennesaw, GA 30144-2085 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2005 |
Last Update Date | 08/07/2007 |