Organization
GEORGIA TRD CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS WAYNE MCCORMACK JR. MD (CEO)
(706) 316-1908
Entity
Organization
Contact information
Practice address
1361 JENNINGS MILL RD STE 201, WATKINSVILLE, GA 30677-7292
(706) 316-1908
(706) 316-2062
Mailing address
1361 JENNINGS MILL RD STE 201, WATKINSVILLE, GA 30677-7292
(706) 316-1908
(706) 316-2062
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
07/12/2023
Last updated
07/12/2023
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