Lytle Brown (NPI# 1710251350, PAC ID# 0749442598) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1710251350 |
| PAC ID by PECOS | 0749442598 |
| Professional Enrollment ID | I20140219001495 |
| Full Name | Lytle Brown |
| Organization Legal Name | EASTSIDE ORTHOCARE LLC |
| Address |
2121 Fountain Dr Suite E Snellville GA 30078-2900 |
| Phone Number | 7709781422 |
| Gender | M |
| Graduation Year | 2011 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 6305945858 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110087 | GWINNETT MEDICAL CENTER |
| 110192 | EASTSIDE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2121 Fountain Dr, Suite E, Snellville, GA 30078-2900 | 7709781422 | EASTSIDE ORTHOCARE LLC |
| Organization Legal Name | EASTSIDE ORTHOCARE LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Craig Mines | Orthopedic Surgery | Eastside Orthocare LLC | 2121 Fountain Dr, Suite E, Snellville, GA 30078-2900 |
| Street Address |
2121 FOUNTAIN DR SUITE E |
| City | SNELLVILLE |
| State | GA |
| Zip | 30078-2900 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jose Dominguez | Internal Medicine | 2121 Fountain Dr, Suite A, Snellville, GA 30078-2900 | |
| Craig Mines | Orthopedic Surgery | Eastside Orthocare LLC | 2121 Fountain Dr, Suite E, Snellville, GA 30078-2900 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley Ann Mire | Certified Registered Nurse Anesthetist (crna) | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Ramanjaneyulu V Dronavalli | Internal Medicine | 2138 Scenic N Hwy A, Snellville, GA 30078 | |
| Jody Meek | Anesthesiology Assistant | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Brittany E Bradley | Certified Registered Nurse Anesthetist (crna) | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Keith Alan Housman | Anesthesiology | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Thien D Quach | Anesthesiology | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Benjamin Lee Hicks | Anesthesiology Assistant | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Geetha Jonnala | Rheumatology | 1567 Janmar Rd, Suite 100, Snellville, GA 30078-0308 | |
| Oyinkansola Akinmade | Physical Therapy | Caretherapy, LLC | 1567 Janmar Rd, Snellville, GA 30078-0309 |
| Allison L Guisasola | Occupational Therapy | Caretherapy, LLC | 1567 Janmar Rd, Snellville, GA 30078-0309 |
| Find all physicians in zip 30078 | |||
| City | SNELLVILLE |
| Zip Code | 30078 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | SNELLVILLE + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.