Aycock, Timothy James

Aycock, Timothy James is an individual health care provider with primary practice located at 115 Habersham Dr , Fayetteville GA 30214. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Aycock, Timothy James can be contacted via phone (770) 461-9944.

Contact Information

Primary practice address
115 Habersham Dr Fayetteville GA 30214
Phone: (770) 461-9944
Fax: (770) 461-9779
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 1928 Georgia

Profile Details

NPI number 1780752618
LBN Legal business name Aycock, Timothy James
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780752618 NPPES
Georgia MEDICAID 00637788A

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