Provider Demographics
NPI:1891937322
Name:BROWN, NINITA HELEN (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:NINITA
Middle Name:HELEN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2700 HIGHWAY 34 E
Mailing Address - Street 2:STE 300
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2315
Mailing Address - Country:US
Mailing Address - Phone:704-234-1930
Mailing Address - Fax:
Practice Address - Street 1:2700 HWY 34 EAST BLDG 300
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265
Practice Address - Country:US
Practice Address - Phone:678-423-7700
Practice Address - Fax:678-423-7710
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA080554207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89016P7Medicaid
2339306OtherMEDICARE GROUP
NC89016P7Medicaid