Provider Demographics
NPI:1205824877
Name:BREZINA, BARTON C (MD)
Entity Type:Individual
Prefix:DR
First Name:BARTON
Middle Name:C
Last Name:BREZINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 GREENE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2385
Mailing Address - Country:US
Mailing Address - Phone:706-722-6900
Mailing Address - Fax:706-721-5118
Practice Address - Street 1:701 GREENE ST STE 200
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2385
Practice Address - Country:US
Practice Address - Phone:706-722-6900
Practice Address - Fax:706-721-5118
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047965207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA622412626Medicaid
GA622412626Medicaid