| F. Richard Blue Phd | |
|
6100 Lake Forrest Dr Nw Ste 510 Atlanta GA 30328-3837 | |
| (404) 705-9770 | |
| (404) 531-0517 |
| Full Name | F. Richard Blue Phd |
|---|---|
| Speciality | Psychologist |
| Location | 6100 Lake Forrest Dr Nw Ste 510, Atlanta, Georgia |
| Authorized Official Name and Position | F. Richard Blue (PSYCHOLOGIST) |
| Authorized Official Contact | 4047059770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| F. Richard Blue Phd 6100 Lake Forrest Dr Nw Ste 510 Atlanta GA 30328-3837 Ph: (404) 705-9770 | F. Richard Blue Phd 6100 Lake Forrest Dr Nw Ste 510 Atlanta GA 30328-3837 Ph: (404) 705-9770 |
| NPI Number | 1083989479 |
|---|---|
| Provider Enumeration Date | 03/19/2012 |
| Last Update Date | 03/19/2012 |
| Medicare PECOS PAC ID | 8426218918 |
|---|---|
| Medicare Enrollment ID | O20120320000724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083989479 | NPI | - | NPPES |
| 00480191B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 515 (Georgia) | Primary |
| Provider Name | F Richard Blue |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477615953 PECOS PAC ID: 0143480632 Enrollment ID: I20120320000747 |
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