Provider Demographics
NPI:1740259480
Name:GARMON, JOSEPH M (PHD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:GARMON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 REMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-5634
Mailing Address - Country:US
Mailing Address - Phone:229-226-0741
Mailing Address - Fax:229-227-9360
Practice Address - Street 1:503 REMINGTON AVE
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-5634
Practice Address - Country:US
Practice Address - Phone:229-226-0741
Practice Address - Fax:229-227-9360
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002910103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAQ28242Medicare UPIN
GA68BBGLFMedicare ID - Type Unspecified