| Matt F Butryn, Phd, Llc | |
|
1 Huntington Rd Suite 802 Athens GA 30606-7204 | |
| (706) 548-0018 | |
| Not Available |
| Full Name | Matt F Butryn, Phd, Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 1 Huntington Rd, Athens, Georgia |
| Authorized Official Name and Position | Matt F Butryn (PRACTICE OWNER) |
| Authorized Official Contact | 7065480018 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Matt F Butryn, Phd, Llc 1 Huntington Rd Suite 802 Athens GA 30606-7204 Ph: (706) 548-0018 | Matt F Butryn, Phd, Llc 1 Huntington Rd Suite 802 Athens GA 30606-7204 Ph: (706) 548-0018 |
| NPI Number | 1942569090 |
|---|---|
| Provider Enumeration Date | 05/10/2012 |
| Last Update Date | 05/10/2012 |
| Medicare PECOS PAC ID | 9638334097 |
|---|---|
| Medicare Enrollment ID | O20120710000283 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942569090 | NPI | - | NPPES |
| 000918222A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 2503 (Georgia) | Primary |
| Provider Name | Matt F Butryn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639158868 PECOS PAC ID: 4486556131 Enrollment ID: I20040122001095 |
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