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General NPI Number Information
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NPI Number | 1518451269
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Entity Type | Individual
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Provider Name | GIDEON LEIGH MATZKIN MD
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Gender | Male
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Dates
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Enumeration Date | 06/17/2018
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 2440 LAWRENCEVILLE HWY STE 200
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City | DECATUR
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State | GA
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Zip | 30033-3267
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Country | US
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Telephone | 470-589-5858
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Fax | 470-589-4040
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Provider Business Mailing Address
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Address Line | 5555 GLENRIDGE CONNECTOR STE 200
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City | ATLANTA
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State | GA
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Zip | 30342-4815
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Country | US
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Telephone | 470-589-5858
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Fax | 470-589-4040
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 87095
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License Number State | GA
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