Azar-Dickens, John
Azar-Dickens, John is an sole proprietor health care provider with primary practice located at 106 E 5Th Ave , Rome GA 30161-3128. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Azar-Dickens, John can be contacted via phone (706) 232-6743.Contact Information
Primary practice address
106 E 5Th Ave
Rome GA 30161-3128
Phone: (706) 232-6743
Fax: (706) 232-8050
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2459 | Georgia |
Profile Details
| NPI number | 1104984103 |
|---|---|
| LBN Legal business name | Azar-Dickens, John |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 4th, 2006 |
| Last updated | Jul 9th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104984103 | NPPES |
| Georgia | MEDICAID | 00895837 |
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