Provider Demographics
NPI:1306805577
Name:KRACHMAN, BRIAN S (DO)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:S
Last Name:KRACHMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:3867 ROSWELL RD NE
Mailing Address - Street 2:STE 100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4452
Mailing Address - Country:US
Mailing Address - Phone:678-904-5611
Mailing Address - Fax:
Practice Address - Street 1:4890 ROSWELL RD
Practice Address - Street 2:SUITE 250
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-2606
Practice Address - Country:US
Practice Address - Phone:404-255-9244
Practice Address - Fax:404-255-9114
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA45272207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F48838Medicare UPIN
TXB111368Medicare PIN
GA00785067AMedicaid
TXP00884297Medicare PIN
GA11BDSDDMedicare PIN
GA110212503OtherRAILROAD MEDICARE