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Individual

DAVID WAYNE AYCOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
115 HABERSHAM DR, FAYETTEVILLE, GA 30214
(770) 461-9944
(770) 461-9779
Mailing address
115 HABERSHAM DR, FAYETTEVILLE, GA 30214
(770) 461-9944
(770) 461-9779

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY1239
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00440349B
GA
01
680015333
RAILROAD MEDICARE
GA
Enumeration date
11/30/2006
Last updated
07/08/2007
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