Healthcare Provider Details

I. General information

NPI: 1578363297
Provider Name (Legal Business Name): RIVER REGION PSYCHIATRY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2025
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4015 S COBB DR SE STE 115
SMYRNA GA
30080-6315
US

IV. Provider business mailing address

233 WINTON BLOUNT LOOP
MONTGOMERY AL
36117-3507
US

V. Phone/Fax

Practice location:
  • Phone: 678-990-1880
  • Fax:
Mailing address:
  • Phone: 334-239-2622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SHANKAR B YALAMANCHILI
Title or Position: OWNER
Credential: MD
Phone: 334-239-2622