Provider Demographics
NPI:1508059544
Name:BROWN, RICHARD K (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:K
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 E OGLETHORPE AVE
Mailing Address - Street 2:SUITE O
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-4139
Mailing Address - Country:US
Mailing Address - Phone:912-447-1885
Mailing Address - Fax:
Practice Address - Street 1:513 E OGLETHORPE AVE
Practice Address - Street 2:SUITE O
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-4139
Practice Address - Country:US
Practice Address - Phone:912-447-1885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006307111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAV04293Medicare UPIN