Timothy Mangum Jr, is a
Psychologist - School based in Sandersville, Georgia. Timothy Mangum Jr is licensed to practice in Texas (license number 72050) and his current practice location is
215 Westlake Dr, Sandersville, Georgia. He can be reached at his office (for appointments etc.) via phone at
(919) 810-3283.
NPI number for Timothy Mangum Jr is 1902612468 and his current mailing address is 215 Westlake Dr, Sandersville, Georgia. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1902612468.
Healthcare Provider's Profile
| Full Name | Timothy Mangum Jr |
|---|
| Gender | Male |
|---|
| Speciality | Psychologist - School |
|---|
| Location | 215 Westlake Dr, Sandersville, Georgia |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1902612468
- Provider Enumeration Date: 12/09/2024
- Last Update Date: 12/09/2024
Medical Identifiers
Medical identifiers for Timothy Mangum Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1902612468 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TS0200X | Psychologist - School | 1297566 (North Carolina) | Secondary |
| 103TS0200X | Psychologist - School | 324407 (South Carolina) | Secondary |
| 103TS0200X | Psychologist - School | 233771 (Nevada) | Secondary |
| 103TS0200X | Psychologist - School | 1962506 (Georgia) | Secondary |
| 103TS0200X | Psychologist - School | 72050 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Timothy Mangum Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Timothy Mangum Jr,
215 Westlake Dr,
Sandersville, GA 31082-9427
Ph: () - | Timothy Mangum Jr,
215 Westlake Dr,
Sandersville, GA 31082-9427
Ph: (919) 810-3283 |
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