| Southeastern Independent Psychiatry, Pc | |
|
17 Oneill St Sw Rome GA 30161-6023 | |
| (706) 235-2475 | |
| (706) 235-2472 |
| Full Name | Southeastern Independent Psychiatry, Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 17 Oneill St Sw, Rome, Georgia |
| Authorized Official Name and Position | Douglas K Laipple (OWNER) |
| Authorized Official Contact | 7062352475 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeastern Independent Psychiatry, Pc 17 Oneill St Sw Rome GA 30161-6023 Ph: (706) 235-2475 | Southeastern Independent Psychiatry, Pc 17 Oneill St Sw Rome GA 30161-6023 Ph: (706) 235-2475 |
| NPI Number | 1134360183 |
|---|---|
| Provider Enumeration Date | 03/19/2009 |
| Last Update Date | 03/19/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134360183 | NPI | - | NPPES |
| 434028712A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 021410 (Georgia) | Primary |
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