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Individual

DIRK E HUTTENBACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4015 S COBB DR SE, SUITE 210, SMYRNA, GA 30080-6303
(770) 434-2436
(770) 434-1223
Mailing address
4015 S COBB DR SE, SUITE 210, SMYRNA, GA 30080-6303
(770) 434-2436
(770) 434-1223

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
013903
GA
2084P0804X
Child & Adolescent Psychiatry Physician
013903
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00089284A
GA
Enumeration date
04/07/2006
Last updated
09/11/2025
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