Provider Demographics
NPI:1790075117
Name:DR. BRIAN K. HOWARD P.C.
Entity Type:Organization
Organization Name:DR. BRIAN K. HOWARD P.C.
Other - Org Name:NORTH FULTON PLASTIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-619-9566
Mailing Address - Street 1:1357 HEMBREE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5722
Mailing Address - Country:US
Mailing Address - Phone:770-619-9566
Mailing Address - Fax:770-619-9597
Practice Address - Street 1:1357 HEMBREE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5722
Practice Address - Country:US
Practice Address - Phone:770-619-9566
Practice Address - Fax:770-619-9597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA45244208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00042313OtherRAILROAD MEDICARE
GA00810235AMedicaid
GA24BCBSXMedicare PIN
GAP00042313OtherRAILROAD MEDICARE