Provider Demographics
NPI:1629159538
Name:THE ALLERGY CENTER AT BROOKSTONE PC
Entity Type:Organization
Organization Name:THE ALLERGY CENTER AT BROOKSTONE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:CHRZANOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-324-4012
Mailing Address - Street 1:1220 BROOKSTONE CENTRE PKWY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-2954
Mailing Address - Country:US
Mailing Address - Phone:706-324-4012
Mailing Address - Fax:706-324-0396
Practice Address - Street 1:1220 BROOKSTONE CENTRE PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-2954
Practice Address - Country:US
Practice Address - Phone:706-324-4012
Practice Address - Fax:706-324-0396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
535026OtherBCBS HMO
60036871OtherBCBS AL
535026OtherBCBS PPO
258780808OtherCHAMP VA
258780808OtherTRICARE PRIME REGION 3
535026OtherBCBS AL ALL KIDS
535026OtherBCBS GA PPO
000635203HOtherPEACH STATE HEALTH PLA
535026OtherBCBS AL GA
535026OtherBCBS POS
535026OtherBCBS FED
535026OtherBCBS GA
60036834OtherBCBS AL
00635203HOtherPEACHCARE FOR KIDS
258780808OtherTRICARE FOR LIFE
258780808OtherTRICARE STANDARD
535025OtherSTATE HEALTH BENEFIT P
P00172885OtherMEDICARE RAILROAD
304868OtherWELLCARE
60036873OtherBCBS AL