Organization
MEDPSYCH SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN SCOTT BARANCHOK PHD (OWNER)
(706) 290-0535
Entity
Organization
Contact information
Practice address
504 RIVERSIDE PKWY NE, SUITE 300, ROME, GA 30161-2982
(706) 290-0535
Mailing address
P.O. BOX 3207, ROME, GA 30164-3207
(706) 290-0535
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PSY002010
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000793174C
—
GA
Enumeration date
02/13/2007
Last updated
06/24/2014
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