Organization Name: | T. ALBERT DAVIS, M.D., PC |
NPI Number: | 1013161322 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS ALBERT DAVIS (PRESIDENT) |
Mailing Address: | 634 Peachtree Pkwy Suite 210 Cumming |
State: | GA US |
Postal Code: | 300419782 |
Phone Number: | 7708881011 |
Fax Number: | 7708886766 |
NPI Enumeration Date: | 11/13/2008 |
NPI Last Update Date: | 11/13/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0850X |
License Number: | 012079 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Mental Health |
Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |