| Behavioral Medicine, Llc | |
|
3585 Vineville Ave Macon GA 31204-1872 | |
| (478) 476-0403 | |
| (478) 476-9533 |
| Full Name | Behavioral Medicine, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 3585 Vineville Ave, Macon, Georgia |
| Authorized Official Name and Position | Christopher J Tillitski (PSYCHOLOGIST/PRESIDENT) |
| Authorized Official Contact | 4784760403 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Medicine, Llc 3585 Vineville Ave Macon GA 31204-1872 Ph: (478) 476-0403 | Behavioral Medicine, Llc 3585 Vineville Ave Macon GA 31204-1872 Ph: (478) 476-0403 |
| NPI Number | 1457534513 |
|---|---|
| Provider Enumeration Date | 12/12/2007 |
| Last Update Date | 12/12/2007 |
| Medicare PECOS PAC ID | 3678722048 |
|---|---|
| Medicare Enrollment ID | O20120927000834 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457534513 | NPI | - | NPPES |
| 68BBDDL | Other | GA | MEDICARE ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 001724 (Georgia) | Primary |
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