Provider Demographics
NPI:1275590481
Name:BROWN, ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
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:PO BOX 5610
Mailing Address - Street 2:
Mailing Address - City:CORDELE
Mailing Address - State:GA
Mailing Address - Zip Code:31010-5610
Mailing Address - Country:US
Mailing Address - Phone:229-273-8881
Mailing Address - Fax:229-273-8985
Practice Address - Street 1:WEST THIRD AVENUE
Practice Address - Street 2:SUITE 500
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701
Practice Address - Country:US
Practice Address - Phone:229-312-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA57782207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC230958Medicaid
SCH841298046Medicare ID - Type Unspecified
SC230958Medicaid