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NPI Code Detail

MEDICARE: MICHAEL POLLOCK

MEDICARE: MICHAEL POLLOCK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1073083762
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL POLLOCK
Provider Business Mailing Address
First Line : PO BOX 1
Second Line :
City : LITHIA SPRINGS
State : GA
Zip : 30122-0001
Country : US
Telephone Number : 770-365-5245
Fax Number :
Provider Business Practice Location Address
First Line : 3725 PRINCETON LAKES PKWY SW APT 7003
Second Line :
City : ATLANTA
State : GA
Zip : 30331-5560
Country : US
Telephone Number : 770-365-5245
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2018
Last Update Date : 11/26/2018

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Directions to “ MICHAEL POLLOCK ” Practice Location

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