| Mjr Enterprises, Pc | |
|
146 Depot St Ste 201 Blue Ridge GA 30513-8627 | |
| (706) 502-9404 | |
| (949) 862-5384 |
| Full Name | Mjr Enterprises, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 146 Depot St Ste 201, Blue Ridge, Georgia |
| Authorized Official Name and Position | A Ronald Seifert (OWNER) |
| Authorized Official Contact | 3606981321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mjr Enterprises, Pc 146 Depot St Ste 201 Blue Ridge GA 30513-8627 Ph: (706) 502-9404 | Mjr Enterprises, Pc 146 Depot St Ste 201 Blue Ridge GA 30513-8627 Ph: (706) 502-9404 |
| NPI Number | 1508155029 |
|---|---|
| Provider Enumeration Date | 04/05/2011 |
| Last Update Date | 08/20/2024 |
| Certification Date | 08/20/2024 |
| Medicare PECOS PAC ID | 2567631914 |
|---|---|
| Medicare Enrollment ID | O20241125003272 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508155029 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Alvin Seifert |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689712119 PECOS PAC ID: 2264621283 Enrollment ID: I20200305002728 |
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