| NPI | 1598855355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN J. MADDOX Provider Enrollment Coordinator 912-350-9335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2008-01-15 |