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General NPI Number Information
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NPI Number | 1033461736
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Entity Type | Organization
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Legal Business Name | IAN I. LIPSITCH, M.D., P.C.
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Dates
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Enumeration Date | 10/05/2012
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Last Update Date | 10/05/2012
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Provider Practice Location Address
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Address Line | 5064 ROSWELL ROAD, N.E. SUITE D-201
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City | ATLANTA
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State | GA
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Zip | 30342-2266
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Country | US
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Telephone | 404-252-4525
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Fax | 404-252-6935
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Provider Business Mailing Address
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Address Line | 5064 ROSWELL ROAD, N.E. SUITE D-201
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City | ATLANTA
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State | GA
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Zip | 30342-2266
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Country | US
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Telephone | 404-252-4525
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Fax | 404-252-6935
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | IAN LIPSITCH
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Credential | M.D.
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Telephone | 404-252-4525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 016385
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License Number State | GA
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