Provider Demographics
NPI:1275839797
Name:DR. NICE PSYCHIATRY LLC
Entity Type:Organization
Organization Name:DR. NICE PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / RENDERING PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:JONES-NICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-253-6001
Mailing Address - Street 1:PO BOX 71819
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30271-1819
Mailing Address - Country:US
Mailing Address - Phone:770-253-6001
Mailing Address - Fax:770-253-6402
Practice Address - Street 1:1933 HIGHWAY 34 E
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-1327
Practice Address - Country:US
Practice Address - Phone:770-253-6001
Practice Address - Fax:770-253-6402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0521242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE51722Medicare UPIN