Provider Demographics
NPI:1790281723
Name:MILLSAPS, BRIANNA (MD)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:MILLSAPS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1756 LOWER HAWTHORNE TRL
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:GA
Mailing Address - Zip Code:39828-6212
Mailing Address - Country:US
Mailing Address - Phone:850-688-3892
Mailing Address - Fax:833-941-2626
Practice Address - Street 1:1 DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:GA
Practice Address - Zip Code:39828-3072
Practice Address - Country:US
Practice Address - Phone:229-378-8110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-30
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME150760207Q00000X
GA89124207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine