Provider Demographics
NPI:1407927361
Name:D R HEALTH SERVICES PC
Entity Type:Organization
Organization Name:D R HEALTH SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:CNS
Authorized Official - Phone:770-778-1349
Mailing Address - Street 1:PO BOX 1576
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30085-1576
Mailing Address - Country:US
Mailing Address - Phone:770-778-1349
Mailing Address - Fax:770-717-6646
Practice Address - Street 1:10 WOLVERTON CT
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-2514
Practice Address - Country:US
Practice Address - Phone:770-778-1349
Practice Address - Fax:770-717-6646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAR102945363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1154358208OtherNPI
GA1154358208OtherNPI