MEDICARE: GEORGIA BIO BEHAVIORAL ASSOCIATES

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1902556632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEORGIA BIO BEHAVIORAL ASSOCIATES

Provider Business Mailing Address
First Line	:	4546 BARCLAY DR STE B
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30338-7146
Country	:	US
Telephone Number	:	770-457-7994
Fax Number	:	770-458-8656

Provider Business Practice Location Address
First Line	:	4546 BARCLAY DR STE B
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30338-7146
Country	:	US
Telephone Number	:	770-457-7994
Fax Number	:	770-458-8656

Authorized Official
Title or Position	:	MD
Name	:	JEFFREY LEE WINSTON
Credential	:	MD
Telephone Number	:	770-457-7994

Provider Enumeration Date	:	03/25/2022
Last Update Date	:	01/20/2025

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