| John Azar-dickens, Ph.d.,pc | |
|
109 John Maddox Dr Nw Rome GA 30165-1451 | |
| (706) 232-6743 | |
| Not Available |
| Full Name | John Azar-dickens, Ph.d.,pc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 109 John Maddox Dr Nw, Rome, Georgia |
| Authorized Official Name and Position | John Azar-dickens (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 7062340659 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John Azar-dickens, Ph.d.,pc Po Box 1008 Rome GA 30162-1008 Ph: (706) 232-6743 | John Azar-dickens, Ph.d.,pc 109 John Maddox Dr Nw Rome GA 30165-1451 Ph: (706) 232-6743 |
| NPI Number | 1093026601 |
|---|---|
| Provider Enumeration Date | 06/29/2010 |
| Last Update Date | 06/29/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093026601 | NPI | - | NPPES |
| 00895837J | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 002459 (Georgia) | Primary |
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