Provider Demographics
NPI:1992264907
Name:BRINKLEY, SOPHIA ELIAS (MD)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:ELIAS
Last Name:BRINKLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SOPHIA
Other - Middle Name:
Other - Last Name:ELIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:241 SILVERWOOD COMMERCIAL DR
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:GA
Mailing Address - Zip Code:31326-5164
Mailing Address - Country:US
Mailing Address - Phone:912-826-8800
Mailing Address - Fax:912-826-8805
Practice Address - Street 1:241 SILVERWOOD COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326-5164
Practice Address - Country:US
Practice Address - Phone:912-826-8800
Practice Address - Fax:912-826-8805
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA87114207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program