Samuel Jermaine Maddox PH.D.

NPI 1093904260 - Psychologist - 103TC2200X

NPI Details
NPI 1093904260
Gender Male
Enumeration Date 10/23/2007
Last Updated 10/23/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1777 NORTHEAST EXPY NE
SUITE 175
ATLANTA GA, 30329-2480, US
Phone (678) 523-0969
Fax (770) 788-7662
Business Location
1777 NORTHEAST EXPY NE
SUITE 175
ATLANTA GA, 30329-2480, US
Phone (678) 523-0969
Fax (770) 788-7662
Toxanomy
Taxonomy Code 103TC2200X
License State Georgia
License Number PSY002983
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According to our database, Dr. Samuel Jermaine Maddox PH.D. NPI is 1093904260, taxonomy code is 103TC2200X and license number is PSY002983, license state is located at Georgia. Samuel Jermaine Maddox PH.D. physically located at 1777 Northeast Expy Ne, Atlanta GA, 30329-2480. NPI Number Samuel Jermaine Maddox PH.D. has the Individual type.

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1093904260 NPI number is provided on an as is basis without warranty of any kind. 1093904260 is maintained by the National Plan & Provider Enumeration System. The contents of Samuel Jermaine Maddox PH.D. are for informational purposes only.