Provider Demographics
NPI:1710299953
Name:BRIGGS MD LLC
Entity Type:Organization
Organization Name:BRIGGS MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVON
Authorized Official - Middle Name:P
Authorized Official - Last Name:BRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-992-2991
Mailing Address - Street 1:920 DANNON VW SW
Mailing Address - Street 2:SUITE 3104
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-2157
Mailing Address - Country:US
Mailing Address - Phone:404-992-2991
Mailing Address - Fax:
Practice Address - Street 1:920 DANNON VW SW
Practice Address - Street 2:SUITE 3104
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-2157
Practice Address - Country:US
Practice Address - Phone:404-992-2991
Practice Address - Fax:404-629-3935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-03
Last Update Date:2010-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA07012011251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health