Provider Demographics
NPI:1811159775
Name:THOMAS M. BROWN, O.D.,P.C.
Entity type:Organization
Organization Name:THOMAS M. BROWN, O.D.,P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:678-438-5438
Mailing Address - Street 1:840 GLYNN ST S
Mailing Address - Street 2:SUITE 344
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-2004
Mailing Address - Country:US
Mailing Address - Phone:770-716-7414
Mailing Address - Fax:770-716-7498
Practice Address - Street 1:840 GLYNN ST S
Practice Address - Street 2:SUITE 344
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-2004
Practice Address - Country:US
Practice Address - Phone:770-716-7414
Practice Address - Fax:770-716-7498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002007152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty