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Individual

DR. KENNETH FRANCIS MCPHERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
2610 CENTRAL AVE, AUGUSTA, GA 30904-5347
(706) 736-1812
(706) 736-0878
Mailing address
PO BOX 3341, AUGUSTA, GA 30914-3341
(706) 736-1812
(706) 736-0878

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1502
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PS0360
MEDICAID
SC
Enumeration date
05/17/2006
Last updated
07/08/2007
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