Provider Demographics
NPI:1376567826
Name:MCKENZIE-BROWN, ANNE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:MCKENZIE-BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 TERRANE RDG
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-4014
Mailing Address - Country:US
Mailing Address - Phone:770-487-7790
Mailing Address - Fax:
Practice Address - Street 1:550 PEACHTREE ST
Practice Address - Street 2:MOT 7TH FLOOR
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30365
Practice Address - Country:US
Practice Address - Phone:404-778-4852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031979207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00050294AMedicaid
GA00050294AMedicaid
GA05BDGZHMedicare ID - Type Unspecified