Provider Demographics
NPI:1982601209
Name:BROWN, ALAN D JR (OD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:D
Last Name:BROWN
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901A PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:STE 500
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5382
Mailing Address - Country:US
Mailing Address - Phone:678-892-2020
Mailing Address - Fax:678-538-1950
Practice Address - Street 1:3975 LAWRENCEVILLE HWY NW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-2817
Practice Address - Country:US
Practice Address - Phone:770-923-5000
Practice Address - Fax:770-717-9325
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000898152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1078920004OtherDME
GA410039100OtherRR MEDICARE
GA478481OtherAETNA HMO
GA598430OtherBCBS
GA598429OtherBCBS
GA00268969DMedicaid
GA2216147OtherUHC
GA4268253OtherAETNA
GA410039100OtherRR MEDICARE
GA478481OtherAETNA HMO
1078920004Medicare NSC