Provider Demographics
NPI:1548037310
Name:BROWN, TYMESHEYA D
Entity type:Individual
Prefix:
First Name:TYMESHEYA
Middle Name:D
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 GA HIGHWAY 32 W
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-4249
Mailing Address - Country:US
Mailing Address - Phone:678-818-9508
Mailing Address - Fax:
Practice Address - Street 1:1510 GA HIGHWAY 32 W
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763-4249
Practice Address - Country:US
Practice Address - Phone:678-818-9508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor