| Kenneth C. Frontman, Ph.d., Pc | |
|
1150 Upper Hembree Rd Roswell GA 30076-1142 | |
| (628) 624-0930 | |
| (678) 624-0730 |
| Full Name | Kenneth C. Frontman, Ph.d., Pc |
|---|---|
| Speciality | Psychologist |
| Location | 1150 Upper Hembree Rd, Roswell, Georgia |
| Authorized Official Name and Position | Kenneth Charles Frontman (PSYCHOLOGIST) |
| Authorized Official Contact | 6786240930 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth C. Frontman, Ph.d., Pc 1150 Upper Hembree Rd Roswell GA 30076-1142 Ph: (628) 624-0930 | Kenneth C. Frontman, Ph.d., Pc 1150 Upper Hembree Rd Roswell GA 30076-1142 Ph: (628) 624-0930 |
| NPI Number | 1609138890 |
|---|---|
| Provider Enumeration Date | 06/13/2012 |
| Last Update Date | 06/13/2012 |
| Medicare PECOS PAC ID | 7517122500 |
|---|---|
| Medicare Enrollment ID | O20120625000384 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609138890 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1835 (Georgia) | Primary |
| Provider Name | Kenneth C Frontman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568525202 PECOS PAC ID: 6608031695 Enrollment ID: I20120626000073 |
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