Provider Demographics
NPI:1760622708
Name:METZEL, ALAN MARSHALL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:MARSHALL
Last Name:METZEL
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 266
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-0006
Mailing Address - Country:US
Mailing Address - Phone:770-733-0521
Mailing Address - Fax:707-265-6618
Practice Address - Street 1:400 DAWSON COMMONS CIR STE 410
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-6269
Practice Address - Country:US
Practice Address - Phone:706-265-1335
Practice Address - Fax:706-265-2296
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002030103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11931432OtherCAQH