| Georgia Trd Clinic, Llc | |
|
1361 Jennings Mill Rd Ste 201 Watkinsville GA 30677-7292 | |
| (706) 316-1908 | |
| (706) 316-2062 |
| Full Name | Georgia Trd Clinic, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1361 Jennings Mill Rd Ste 201, Watkinsville, Georgia |
| Authorized Official Name and Position | Thomas Wayne Mccormack (CEO) |
| Authorized Official Contact | 7063161908 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Georgia Trd Clinic, Llc 1361 Jennings Mill Rd Ste 201 Watkinsville GA 30677-7292 Ph: (706) 316-1908 | Georgia Trd Clinic, Llc 1361 Jennings Mill Rd Ste 201 Watkinsville GA 30677-7292 Ph: (706) 316-1908 |
| NPI Number | 1376222075 |
|---|---|
| Provider Enumeration Date | 07/12/2023 |
| Last Update Date | 07/12/2023 |
| Certification Date | 07/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376222075 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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