Organization
ALBANY ADDICTION ASSOCIATES, INC. D/B/A PRIVATE CLINIC ALBANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN PAUL CONNELL M.A. (PRESIDENT)
(229) 903-0022
Entity
Organization
Contact information
Practice address
2607 LEDO RD, ALBANY, GA 31707-1211
(229) 903-0022
(229) 903-0025
Mailing address
2607 LEDO RD, ALBANY, GA 31707-1211
(229) 903-0022
(229) 903-0025
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
PHOP000026
GA
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
NTP001025
GA
Other
Enumeration date
07/22/2010
Last updated
07/22/2010
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