Provider Demographics
NPI:1073702916
Name:ARCHER, BRENT JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:JOSEPH
Last Name:ARCHER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1240 JESSE JEWELL PKWY SE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3862
Mailing Address - Country:US
Mailing Address - Phone:770-536-9864
Mailing Address - Fax:770-297-5011
Practice Address - Street 1:1240 JESSE JEWELL PKWY SE
Practice Address - Street 2:SUITE 500
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3862
Practice Address - Country:US
Practice Address - Phone:770-536-9864
Practice Address - Fax:770-297-5011
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2020-10-13
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Provider Licenses
StateLicense IDTaxonomies
GA062307207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine