| Psy-visions Of Ga, Llc | |
|
300 Medical Dr Suite 705 Lagrange GA 30240-4130 | |
| (706) 885-0111 | |
| (706) 885-0607 |
| Full Name | Psy-visions Of Ga, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 300 Medical Dr, Lagrange, Georgia |
| Authorized Official Name and Position | Mark Douglas Stracks (PSYCHIATRIST/OWNER) |
| Authorized Official Contact | 7068850111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psy-visions Of Ga, Llc 300 Medical Dr Suite 705 Lagrange GA 30240-4130 Ph: (706) 885-0111 | Psy-visions Of Ga, Llc 300 Medical Dr Suite 705 Lagrange GA 30240-4130 Ph: (706) 885-0111 |
| NPI Number | 1538302864 |
|---|---|
| Provider Enumeration Date | 04/16/2009 |
| Last Update Date | 04/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538302864 | NPI | - | NPPES |
| 567393386A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 060311 (Georgia) | Primary |
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