Provider Demographics
NPI:1821114224
Name:PERIMETER PRIMARY CARE P.C.
Entity Type:Organization
Organization Name:PERIMETER PRIMARY CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-391-0552
Mailing Address - Street 1:5885 GLENRIDGE DR NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5573
Mailing Address - Country:US
Mailing Address - Phone:770-391-0552
Mailing Address - Fax:770-395-9344
Practice Address - Street 1:5885 GLENRIDGE DR NE
Practice Address - Street 2:SUITE 200
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-5512
Practice Address - Country:US
Practice Address - Phone:770-391-0552
Practice Address - Fax:770-395-9344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0100115OtherUNITED HEALTHCARE
2680342014OtherCIGNA
52580105001OtherBCBS OF GEORGIA
GA5632093OtherAETNA
GA0100115OtherUNITED HEALTHCARE
GAF45697Medicare UPIN