| David C Ghostley Psyd Inc | |
|
202 N Bell St Dothan AL 36303-4310 | |
| (334) 699-1620 | |
| Not Available |
| Full Name | David C Ghostley Psyd Inc |
|---|---|
| Speciality | Psychologist |
| Location | 202 N Bell St, Dothan, Alabama |
| Authorized Official Name and Position | David Carl Ghostley (OWNER) |
| Authorized Official Contact | 3346991620 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David C Ghostley Psyd Inc 202 N Bell St Dothan AL 36303-4310 Ph: (334) 699-1620 | David C Ghostley Psyd Inc 202 N Bell St Dothan AL 36303-4310 Ph: (334) 699-1620 |
| NPI Number | 1225079114 |
|---|---|
| Provider Enumeration Date | 06/09/2006 |
| Last Update Date | 08/19/2013 |
| Medicare PECOS PAC ID | 2769446004 |
|---|---|
| Medicare Enrollment ID | O20041116000750 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225079114 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1262 (Alabama) | Primary |
| Provider Name | David C Ghostley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265489538 PECOS PAC ID: 5193629103 Enrollment ID: I20031121000329 |
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