Provider Demographics
NPI:1295906840
Name:BROWN, GINA I (DC)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:I
Last Name:BROWN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 E OGLETHORPE AVE
Mailing Address - Street 2:SUITE O
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-4139
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:513 E OGLETHORPE AVE
Practice Address - Street 2:SUITE O
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-4139
Practice Address - Country:US
Practice Address - Phone:912-447-1885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006248111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCJCKMedicare PIN
GAV04292Medicare UPIN