Doctor Name: | THEODORE JOSEPH ANFINSON |
NPI Number: | 1992838718 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 36915 |
Business Practice Address: | 450 Winn Way Decatur, GA - 300301715 |
Business Phone Number: | 4042940499 |
Business Fax Number: | 4045086421 |
Mailing Address: | 450 Winn Way, DECATUR |
State: | GA |
Postal Code: | 300301715 |
Phone Number: | 4042940499 |
Fax Number: | 4045086421 |
NPI Enumeration Date: | 03/13/2007 |
NPI Last Update Date: | 11/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 36915 |
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 |