MEDICARE: DR. GERALD F. FALLS PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY001085	GA
2	103TC0700X	Clinical Psychologist	588	AL
3	103TC0700X	Clinical Psychologist	PY0003703	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	021186	OTHER	GA	TRICARE
2	52428441001	OTHER	GA	BLUECROSS BLUESHIELD-GA
3	217945784	OTHER	GA	UNITED BEHAVIORAL HEALTH
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	021186	OTHER	GA	VALUEOPTIONS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104887512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERALD F. FALLS PHD

Provider Business Mailing Address
First Line	:	1922 WILLOW RUN DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32312-3732
Country	:	US
Telephone Number	:	850-443-5936
Fax Number	:

Provider Business Practice Location Address
First Line	:	1922 WILLOW RUN DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32312-3732
Country	:	US
Telephone Number	:	850-443-5936
Fax Number	:	850-893-4387

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	10/04/2023

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