| Richard Born, Ph.d. Llc | |
|
1 Huntington Rd #205 Athens GA 30606-7204 | |
| (706) 543-7605 | |
| (706) 543-2397 |
| Full Name | Richard Born, Ph.d. Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1 Huntington Rd, Athens, Georgia |
| Authorized Official Name and Position | Richard Born (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 7065437605 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Born, Ph.d. Llc 1 Huntington Rd #205 Athens GA 30606-7204 Ph: (706) 543-7605 | Richard Born, Ph.d. Llc 1 Huntington Rd #205 Athens GA 30606-7204 Ph: (706) 543-7605 |
| NPI Number | 1225221492 |
|---|---|
| Provider Enumeration Date | 08/21/2007 |
| Last Update Date | 11/16/2007 |
| Medicare PECOS PAC ID | 8325015142 |
|---|---|
| Medicare Enrollment ID | O20040913000295 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225221492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY001283 (Georgia) | Primary |
| Provider Name | Richard R Born |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902895089 PECOS PAC ID: 3678540408 Enrollment ID: I20040915000386 |
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