Dr Samuel Jermaine Maddox, PHD - Psychologist in Atlanta, GA

Dr Samuel Jermaine Maddox, PHD is a Psychologist - Clinical based in Atlanta, Georgia. Dr Samuel Jermaine Maddox is licensed to practice in Georgia (license number PSY002983) and his current practice location is 1777 Northeast Expy Ne, Suite 175, Atlanta, Georgia. He can be reached at his office (for appointments etc.) via phone at (678) 523-0969.

NPI number for Dr Samuel Jermaine Maddox is 1093904260 and his current mailing address is 1777 Northeast Expy Ne, Suite 175, Atlanta, Georgia. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1093904260.

Contact Information

Dr Samuel Jermaine Maddox, PHD
1777 Northeast Expy Ne, Suite 175,
Atlanta, GA 30329-2480
(678) 523-0969
(770) 788-7662



Healthcare Provider's Profile

Full NameDr Samuel Jermaine Maddox
GenderMale
SpecialityPsychologist - Clinical
Location1777 Northeast Expy Ne, Atlanta, Georgia
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1093904260
  • Provider Enumeration Date: 10/23/2007
  • Last Update Date: 10/23/2007

Medical Identifiers

Medical identifiers for Dr Samuel Jermaine Maddox such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1093904260NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical PSY002983 (Georgia)Primary
103TC2200XPsychologist - Clinical Child & Adolescent PSY002983 (Georgia)Secondary
103TF0000XPsychologist - Family PSY002983 (Georgia)Secondary
103TM1800XPsychologist - Intellectual & Developmental Disabilities PSY002983 (Georgia)Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Samuel Jermaine Maddox is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Samuel Jermaine Maddox, PHD
1777 Northeast Expy Ne, Suite 175,
Atlanta, GA 30329-2480

Ph: (678) 523-0969
Dr Samuel Jermaine Maddox, PHD
1777 Northeast Expy Ne, Suite 175,
Atlanta, GA 30329-2480

Ph: (678) 523-0969

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› Verified 2 days ago


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