Provider Demographics
NPI:1710484969
Name:CARTWRIGHT, BRIELLE MARKS (MD)
Entity Type:Individual
Prefix:
First Name:BRIELLE
Middle Name:MARKS
Last Name:CARTWRIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRIELLE
Other - Middle Name:A
Other - Last Name:MARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:380 HOSPITAL DR STE 430
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31217-8017
Mailing Address - Country:US
Mailing Address - Phone:215-815-9090
Mailing Address - Fax:
Practice Address - Street 1:340 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-3838
Practice Address - Country:US
Practice Address - Phone:478-219-7735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA840972084P0800X
GA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry