| Dr Thomas W Mccormack Jr, MD | |
|
1361 Jennings Mill Road, Building 200 Suite 201, Bogart, GA 30622 | |
| (706) 316-1908 | |
| (706) 316-2062 |
| Full Name | Dr Thomas W Mccormack Jr |
|---|---|
| Gender | Male |
| Speciality | Psychiatry |
| Experience | 29 Years |
| Location | 1361 Jennings Mill Road, Bogart, Georgia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740298728 | NPI | - | NPPES |
| 00958625A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | GA051255 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Piedmont Athens Regional Medical Center | Athens, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Athens Behavioral Medicine | 5294756326 | 2 |
| Entity Name | Athens Behavioral Medicine |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902026347 PECOS PAC ID: 5294756326 Enrollment ID: O20051216000028 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Thomas W Mccormack Jr, MD 1361 Jennings Mill Road, Building 200 Suite 201, Bogart, GA 30622 Ph: (706) 316-1908 | Dr Thomas W Mccormack Jr, MD 1361 Jennings Mill Road, Building 200 Suite 201, Bogart, GA 30622 Ph: (706) 316-1908 |
Mr. Edward J Fisher Jr., MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1361 Jennings Mill Road, Building 200 Suite 201, Bogart, GA 30622 Phone: 706-316-1908 Fax: 706-316-2062 | |
Dr. Kayln Tiffany Lane, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1361 Jennings Mill Rd Ste 201, Bogart, GA 30622 Phone: 706-316-1908 Fax: 706-316-2062 |