Provider Demographics
NPI:1972985273
Name:BROWN, SHELDON
Entity type:Individual
Prefix:
First Name:SHELDON
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 N HOUSTON RD STE 103
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-8944
Mailing Address - Country:US
Mailing Address - Phone:478-352-7001
Mailing Address - Fax:478-352-7003
Practice Address - Street 1:233 N HOUSTON RD STE 103
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-8944
Practice Address - Country:US
Practice Address - Phone:478-352-7001
Practice Address - Fax:478-352-7003
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TRN22173390200000X
GA834172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program