Provider Demographics
NPI:1003505132
Name:JAMESTOWN PSYCHIATRIC PC
Entity Type:Organization
Organization Name:JAMESTOWN PSYCHIATRIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-526-4041
Mailing Address - Street 1:1465 FOOTE AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-9383
Mailing Address - Country:US
Mailing Address - Phone:716-526-4041
Mailing Address - Fax:716-526-4161
Practice Address - Street 1:20 GILLIS AVE
Practice Address - Street 2:
Practice Address - City:RIDGWAY
Practice Address - State:PA
Practice Address - Zip Code:15853-1604
Practice Address - Country:US
Practice Address - Phone:814-772-5741
Practice Address - Fax:716-526-4161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty