NPI age
5 years
Enumerated 2021-03-31
Across 1678 active psychiatry & neurology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 97764 | MEDICAL LICENSE |
| 01 (GA) | 12765 | GEORGIA TRAINING PERMIT |
| 01 (GA) | 052996519 | DRIVERS LICENSE NUMBER |
Part of a multi-provider practice. 54 other active providers share this practice address in NPPES.
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