Provider Demographics
NPI:1467673350
Name:MARK J. PRIGATANO, PH.D.
Entity Type:Organization
Organization Name:MARK J. PRIGATANO, PH.D.
Other - Org Name:THE ATTENTION DISORDERS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:PRIGATANO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:478-746-2333
Mailing Address - Street 1:146 PIERCE AVE
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-2871
Mailing Address - Country:US
Mailing Address - Phone:478-746-2333
Mailing Address - Fax:478-746-2380
Practice Address - Street 1:146 PIERCE AVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-2871
Practice Address - Country:US
Practice Address - Phone:478-746-2333
Practice Address - Fax:478-746-2380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY001999103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty