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Organization

JAMES E. STARK, PH.D., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMES EDWIN STARK PH.D. (PRESIDENT)
(770) 541-9988
Entity
Organization

Contact information

Practice address
1755 THE EXCHANGE SE, SUITE 375, ATLANTA, GA 30339-7400
(770) 541-9988
(770) 541-9977
Mailing address
1755 THE EXCHANGE SE, SUITE 375, ATLANTA, GA 30339-7400
(770) 541-9988
(770) 541-9977

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
PSY298
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000041544A
GA
Enumeration date
11/20/2008
Last updated
11/20/2008
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