Provider Demographics
NPI:1487697124
Name:ARRINGTON, GERTRUDE BROWN (MD)
Entity type:Individual
Prefix:
First Name:GERTRUDE
Middle Name:BROWN
Last Name:ARRINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GERTRUDE
Other - Middle Name:B
Other - Last Name:ARRINGTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1720 PHOENIX BLVD
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349
Mailing Address - Country:US
Mailing Address - Phone:770-909-8007
Mailing Address - Fax:770-909-8005
Practice Address - Street 1:1720 PHOENIX BLVD
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349
Practice Address - Country:US
Practice Address - Phone:770-909-8007
Practice Address - Fax:770-909-8005
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA027036208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000298053EMedicaid
GA000298053EMedicaid
37BBFLXMedicare ID - Type Unspecified