Stark, James Edwin

Stark, James Edwin is an sole proprietor health care provider with primary practice located at 1755 The Exchange Se Suite 375, Atlanta GA 30339-7400. He recently has only one registered license in Behavioral Health & Social Service Providers / Forensic, which is considered as his primary health care specialty. Stark, James Edwin can be contacted via phone (770) 541-9988.

Contact Information

Primary practice address
1755 The Exchange Se Suite 375 Atlanta GA 30339-7400
Phone: (770) 541-9988
Fax: (770) 541-9977
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Forensic 103TF0200X 298 Georgia

Profile Details

NPI number 1356492037
LBN Legal business name Stark, James Edwin
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 16th, 2007
Last updated Jan 14th, 2009 - about 16 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 1356492037 NPPES
Georgia MEDICAID 000041544A

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