Provider Demographics
NPI:1033979950
Name:RICK KILMER PHD PC
Entity Type:Organization
Organization Name:RICK KILMER PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:D
Authorized Official - Last Name:KILMER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:770-597-4909
Mailing Address - Street 1:3065 CARDINAL LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3929
Mailing Address - Country:US
Mailing Address - Phone:770-597-4909
Mailing Address - Fax:
Practice Address - Street 1:3066 CARDINAL LAKE CIR
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3985
Practice Address - Country:US
Practice Address - Phone:770-597-4909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)