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NPI Code Detail

MEDICARE: DR. CHARLES A. DILLION PHD

MEDICARE:  DR. CHARLES A. DILLION  PHD
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
1103T00000XPsychologist0799GA
2103T00000XPsychologist799GA
3103TA0400XAddiction (Substance Use Disorder) Psychologist799GA
4103TC0700XClinical Psychologist799GA

General Provider Information

NPI Number : 1336126507
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES A. DILLION PHD
Provider Business Mailing Address
First Line : 2086 FARIWAY CIRCLE
Second Line :
City : ATLANTA
State : GA
Zip : 30319
Country : US
Telephone Number : 404-325-7405
Fax Number :
Provider Business Practice Location Address
First Line : 2089 FAIRWAY CIRCLE
Second Line :
City : ATLANTA
State : GA
Zip : 30319
Country : US
Telephone Number : 678-216-0247
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2005
Last Update Date : 04/24/2009

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Directions to “ DR. CHARLES A. DILLION PHD” Practice Location

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