Samuel Jermaine Maddox in Atlanta - Clinical Child & Adolescent

Samuel Jermaine Maddox - NPI 1093904260

Samuel Jermaine Maddox is a Clinical Child & Adolescent in Atlanta, Georgia. Samuel Jermaine Maddox practices all healthcare services and medical treatments related to Clinical Child & Adolescent. The NPI Number for Samuel Jermaine Maddox is 1093904260. The last update date is 2007-10-23.

Samuel Jermaine Maddox's current location address is 1777 Northeast Expy Ne, Atlanta, Georgia. You can contact this provider via phone number 6785230969 and fax number 7707887662. The mailing address for Samuel Jermaine Maddox is 1777 Northeast Expy Ne, Atlanta, Georgia. To know further, please read the information below!

Provider Profile Detail

Provider Name Samuel Jermaine Maddox
Address 1777 Northeast Expy Ne, Atlanta, Georgia
Phone Number 6785230969
Fax Number 7707887662
Sole Proprietor Y
Credentials PH.D.

NPI Number Detail

NPI Number 1093904260
Provider Enumeration Date 2007-10-23
Last Updated Date 2007-10-23

Provider Mailing Address Detail

Address 1777 Northeast Expy Ne
City Atlanta
State Georgia (GA)
Post Code 303292480
Phone Number 6785230969
Fax Number 7707887662

Provider's Primary Taxonomy Detail

Speciality Clinical Child & Adolescent
Taxonomy 103Tc2200X
Licence No PSY002983
Definition:
A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology

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FAQs about Samuel Jermaine Maddox

What is the Samuel Jermaine Maddox's unique identification number?

The Samuel Jermaine Maddox has been assigned the NPI (National Provider Identifier) Number 1093904260 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.

Could you share the physical location details of Samuel Jermaine Maddox?

The Samuel Jermaine Maddox is situated at 1777 Northeast Expy Ne, in the city of Atlanta, state of GA, with the zip code 303292480.

What is the area of specialization for Samuel Jermaine Maddox, and what is the corresponding taxonomy classification code for this field?

The specialized field of practice for Samuel Jermaine Maddox is Clinical Child & Adolescent, and the corresponding taxonomy code that categorizes this area of expertise is 103Tc2200X.

On what date did the Centers for Medicare & Medicaid Services assign the 1093904260 to Samuel Jermaine Maddox?

The Centers for Medicare & Medicaid Services assigned the 1093904260 to Samuel Jermaine Maddox on 2007-10-23.

As of what date was the information pertaining to Samuel Jermaine Maddox, such as address, specialty, and other details, last reviewed and confirmed to be accurate?

The information related to Samuel Jermaine Maddox, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2007-10-23.

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