Robert Wilson Deloatch Ix, is a
Military Health Care Provider based in Atlanta, Georgia. Robert Wilson Deloatch Ix is licensed to practice in Georgia (license number 62419) and his current practice location is
5260 Campbellton Rd Sw, Atlanta, Georgia. He can be reached at his office (for appointments etc.) via phone at
(404) 349-3049.
NPI number for Robert Wilson Deloatch Ix is 1144347667 and his current mailing address is 5260 Campbellton Rd Sw, Atlanta, Georgia. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1144347667.
Healthcare Provider's Profile
| Full Name | Robert Wilson Deloatch Ix |
|---|
| Gender | Male |
|---|
| Speciality | Military Health Care Provider |
|---|
| Location | 5260 Campbellton Rd Sw, Atlanta, Georgia |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1144347667
- Provider Enumeration Date: 03/22/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Robert Wilson Deloatch Ix such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1144347667 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YP2500X | Counselor - Professional | 62419 (Georgia) | Primary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 62419 (Georgia) | Primary |
| 171000000X | Military Health Care Provider | 62419 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Robert Wilson Deloatch Ix is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Robert Wilson Deloatch Ix,
5260 Campbellton Rd Sw,
Atlanta, GA 30331-7712
Ph: (404) 349-3049 | Robert Wilson Deloatch Ix,
5260 Campbellton Rd Sw,
Atlanta, GA 30331-7712
Ph: (404) 349-3049 |
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