Provider Demographics
NPI:1639255045
Name:PRECIOUS L. BRASWELL, MD, OB/GYN, LLC
Entity Type:Organization
Organization Name:PRECIOUS L. BRASWELL, MD, OB/GYN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PRECIOUS
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRASWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-344-9333
Mailing Address - Street 1:2885 HEADLAND DR
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-6652
Mailing Address - Country:US
Mailing Address - Phone:404-344-9333
Mailing Address - Fax:404-344-9922
Practice Address - Street 1:2885 HEADLAND DR
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-6652
Practice Address - Country:US
Practice Address - Phone:404-344-9333
Practice Address - Fax:404-344-9922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========OtherTAX ID