Provider Demographics
NPI:1275693459
Name:BROWN, REAY H (MD)
Entity Type:Individual
Prefix:DR
First Name:REAY
Middle Name:H
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5730 GLENRIDGE DR NE
Mailing Address - Street 2:SUITE120
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-6141
Mailing Address - Country:US
Mailing Address - Phone:404-252-1194
Mailing Address - Fax:404-252-3150
Practice Address - Street 1:5730 GLENRIDGE DR NE
Practice Address - Street 2:SUITE120
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-6141
Practice Address - Country:US
Practice Address - Phone:404-252-1194
Practice Address - Fax:404-252-3150
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2017-08-31
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Provider Licenses
StateLicense IDTaxonomies
GA30728207W00000X, 207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA581161122OtherTAX ID
GAC13831Medicare UPIN
GA1017150001Medicare NSC
GAGRP3414Medicare ID - Type Unspecified