Provider Demographics
NPI:1992938310
Name:MCGAULEY, BRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:MCGAULEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 E CONFEDERATE AVE SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-2534
Mailing Address - Country:US
Mailing Address - Phone:404-890-6985
Mailing Address - Fax:678-496-4575
Practice Address - Street 1:845 E CONFEDERATE AVE SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30316-2534
Practice Address - Country:US
Practice Address - Phone:404-890-6985
Practice Address - Fax:678-496-4575
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA037293208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine