Dpm Brissett Nrga Llc | |
5124 Grove Field Pt, Lithonia, GA 30038-2387 | |
(646) 721-2072 | |
(866) 678-9749 |
Full Name | Dpm Brissett Nrga Llc |
---|---|
Type | Facility |
Speciality | Podiatrist |
Location | 5124 Grove Field Pt, Lithonia, Georgia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326040114 | NPI | - | NPPES |
48SCIQW | Other | GA | MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | POD000950 (Georgia) | Primary |
Provider Name | Robert P Brissett |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1912999004 PECOS PAC ID: 4587612023 Enrollment ID: I20050111000586 |
Mailing Address | Practice Location Address |
---|---|
Dpm Brissett Nrga Llc 5124 Grove Field Pt, Lithonia, GA 30038-2387 Ph: (646) 721-2072 | Dpm Brissett Nrga Llc 5124 Grove Field Pt, Lithonia, GA 30038-2387 Ph: (646) 721-2072 |
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