Organization Name: | ALBANY ADDICTION ASSOCIATES, INC. D/B/A PRIVATE CLINIC ALBANY |
NPI Number: | 1124331970 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JONATHAN PAUL CONNELL (PRESIDENT) |
Mailing Address: | 2607 Ledo Rd Albany |
State: | GA US |
Postal Code: | 317071211 |
Phone Number: | 2299030022 |
Fax Number: | 2299030025 |
NPI Enumeration Date: | 07/22/2010 |
NPI Last Update Date: | 07/22/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | NTP001025 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |