Provider Demographics
NPI:1285517359
Name:MARK BRAUNSTEIN PSYCHIATRIC GROUP AT STILLWELL PC
Entity type:Organization
Organization Name:MARK BRAUNSTEIN PSYCHIATRIC GROUP AT STILLWELL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAUNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:706-225-9123
Mailing Address - Street 1:1021 BAXTER ST STE A
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-6385
Mailing Address - Country:US
Mailing Address - Phone:706-225-9123
Mailing Address - Fax:
Practice Address - Street 1:1021 BAXTER ST STE A
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-6385
Practice Address - Country:US
Practice Address - Phone:706-225-9123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty