Developmental Behavioral Pediatrics

LBN: Jack W Miller
Developmental Behavioral Pediatrics is an health care organization with primary practice located at 100 Professional Pl Ste 104, Carrollton GA 30117-3874. The organization recently has only one registered license in Ambulatory Health Care Facilities / Adult Mental Health, which is considered as the primary health care specialty. Jack W Miller can be contacted via phone (770) 830-7039, or through Miller, Jack W via phone (770) 830-7039.

Contact Information

Primary practice address
100 Professional Pl Ste 104 Carrollton GA 30117-3874
Phone: (770) 830-7039
Fax: (770) 830-7149
Website:
Map and Directions
Authorized official contact:
Name: Miller, Jack W Doctor of Medicine (MD)
Phone: (770) 830-7039

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X 044541 Georgia

Profile Details

NPI number 1982708368
LBN Legal business name Jack W Miller
DBA Doing business as Developmental Behavioral Pediatrics
Authorized official Miller, Jack W Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 7th, 2006
Last updated Feb 2nd, 2011 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982708368 NPPES
Georgia MEDICAID 000767709C

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