MEDICARE: DR. CYNTHIA LEE GILLIKIN M.D. PH.D.

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	70116	GA

General Provider Information

NPI Number	:	1922399203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA LEE GILLIKIN M.D. PH.D.

Provider Business Mailing Address
First Line	:	8800 ROSWELL RD
Second Line	:	SUITE A-135
City	:	ATLANTA
State	:	GA
Zip	:	30350-1826
Country	:	US
Telephone Number	:	404-682-1923
Fax Number	:	617-326-3783

Provider Business Practice Location Address
First Line	:	8800 ROSWELL RD
Second Line	:	SUITE A-135
City	:	ATLANTA
State	:	GA
Zip	:	30350-1826
Country	:	US
Telephone Number	:	404-682-1923
Fax Number	:	617-326-3783

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

Provider Enumeration Date	:	04/21/2011
Last Update Date	:	03/17/2018

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