Provider Demographics
NPI:1215015672
Name:ORGAN, BRIAN CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CHRISTOPHER
Last Name:ORGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 54208
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-0208
Mailing Address - Country:US
Mailing Address - Phone:404-588-1717
Mailing Address - Fax:404-588-1731
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:SUITE 1577
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2212
Practice Address - Country:US
Practice Address - Phone:404-588-1717
Practice Address - Fax:404-588-1731
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA030418208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00377957EMedicaid
GA00377957EMedicaid
GAD30398Medicare UPIN