Healthcare Provider Details

I. General information

NPI: 1568025005
Provider Name (Legal Business Name): FRANKLIN NNAMDI EZEH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2019
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2946 CLIFTON SPRINGS RD
DECATUR GA
30034-3820
US

IV. Provider business mailing address

225 MARKET PLACE CONNECTOR # 1159
PEACHTREE CITY GA
30269-3542
US

V. Phone/Fax

Practice location:
  • Phone: 404-508-6500
  • Fax:
Mailing address:
  • Phone: 470-400-7014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number92825
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number92825
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: