Brickle, Susan
Brickle, Susan is an individual health care provider with primary practice located at 120 E Carter Ave , Blackshear GA 31516-1561. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Brickle, Susan can be contacted via phone (912) 449-4426.Contact Information
Primary practice address
120 E Carter Ave
Blackshear GA 31516-1561
Phone: (912) 449-4426
Fax: (912) 449-1059
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 031883 | Georgia |
Profile Details
| NPI number | 1407876188 |
|---|---|
| LBN Legal business name | Brickle, Susan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 19th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407876188 | NPPES |
| Georgia | MEDICAID | 00734467E |
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