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General NPI Number Information
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NPI Number | 1275839797
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Entity Type | Organization
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Legal Business Name | DR. NICE PSYCHIATRY LLC
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Dates
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Enumeration Date | 01/31/2011
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Last Update Date | 03/11/2016
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Provider Practice Location Address
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Address Line | 1933 HIGHWAY 34 E
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City | NEWNAN
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State | GA
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Zip | 30265-1327
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Country | US
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Telephone | 770-253-6001
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Fax | 770-253-6402
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Provider Business Mailing Address
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Address Line | PO BOX 71819
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City | NEWNAN
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State | GA
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Zip | 30271-1819
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Country | US
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Telephone | 770-253-6001
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Fax | 770-253-6402
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Authorized Official
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Title or Position | OWNER / RENDERING PROVIDER
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Name | DR. PATRICIA G JONES-NICE
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Credential | MD
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Telephone | 770-253-6001
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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 | 052124
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License Number State | GA
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