Provider Demographics
NPI:1265862270
Name:S. CAROLYN ACKER, MD, LLC
Entity Type:Organization
Organization Name:S. CAROLYN ACKER, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:S.
Authorized Official - Middle Name:CAROLYN
Authorized Official - Last Name:ACKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-633-0990
Mailing Address - Street 1:2801 BUFORD HWY NE
Mailing Address - Street 2:SUITE 290
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2149
Mailing Address - Country:US
Mailing Address - Phone:404-633-0990
Mailing Address - Fax:
Practice Address - Street 1:2801 BUFORD HWY NE
Practice Address - Street 2:SUITE 290
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2149
Practice Address - Country:US
Practice Address - Phone:404-633-0990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty