Provider Demographics
NPI:1164951752
Name:BROWN, SKYLER RYAN (DO)
Entity Type:Individual
Prefix:DR
First Name:SKYLER
Middle Name:RYAN
Last Name:BROWN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5123 E TIMBALIER CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-1775
Mailing Address - Country:US
Mailing Address - Phone:706-505-4396
Mailing Address - Fax:
Practice Address - Street 1:3471 COURTYARD WAY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-5379
Practice Address - Country:US
Practice Address - Phone:706-813-4420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-07
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1913207Q00000X
390200000X
GA97334207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program