Provider Demographics
NPI:1013178722
Name:BROWN CHIROPRACTIC
Entity Type:Organization
Organization Name:BROWN CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:K
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:912-447-1885
Mailing Address - Street 1:513 E OGLETHORPE AVE
Mailing Address - Street 2:SUITE O
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-4139
Mailing Address - Country:US
Mailing Address - Phone:912-447-1885
Mailing Address - Fax:
Practice Address - Street 1:513 E OGLETHORPE AVE
Practice Address - Street 2:SUITE O
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-4139
Practice Address - Country:US
Practice Address - Phone:912-447-1885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006307111N00000X
GACHIR006248111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP7032Medicare PIN