Organization
MARK F BRECHTEL PHD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK F BRECHTEL PHD (PRESIDENT)
(706) 372-6199
Entity
Organization
Contact information
Practice address
1 HUNTINGTON RD, STE 103, ATHENS, GA 30606-7204
(706) 369-0970
Mailing address
428 SAWDUST TRL, NICHOLSON, GA 30565-3097
(706) 372-6199
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
PSY002805
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1162893
CAQH
GA
01
—
1932215845
CLINICIAN NPI
GA
01
—
68BBGLB
MEDICARE B
GA
05
—
750409758A
—
GA
Enumeration date
07/05/2009
Last updated
03/01/2011
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