Psy-Visions Of Ga, Llc

LBN: Psy-Visions Of Ga, Llc
Psy-Visions Of Ga, Llc is an health care organization with primary practice located at 300 Medical Dr Suite 705, Lagrange GA 30240-4130. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as the primary health care specialty. Psy-Visions Of Ga, Llc can be contacted via phone (706) 885-0111, or through Stracks, Mark Douglas via phone (706) 885-0111.

Contact Information

Primary practice address
300 Medical Dr Suite 705 Lagrange GA 30240-4130
Phone: (706) 885-0111
Fax: (706) 885-0607
Website:
Map and Directions
Authorized official contact:
Name: Stracks, Mark Douglas Doctor of Medicine (MD)
Phone: (706) 885-0111

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 060311 Georgia

Profile Details

NPI number 1538302864
LBN Legal business name Psy-Visions Of Ga, Llc
DBA Doing business as
Authorized official Stracks, Mark Douglas Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 16th, 2009
Last updated Apr 16th, 2009 - about 15 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 1538302864 NPPES
Georgia MEDICAID 567393386A

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