MEDICARE: ATLANTA PSYCHIATRIC INSTITUTE

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
1	2084P0800X	Psychiatry Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	GRP2056	OTHER	GA	MEDICARE GROUP NUMBER

General Provider Information

NPI Number	:	1659313195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTA PSYCHIATRIC INSTITUTE

Provider Business Mailing Address
First Line	:	PO BOX 27270
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31221-7270
Country	:	US
Telephone Number	:	478-405-5880
Fax Number	:	478-405-5992

Provider Business Practice Location Address
First Line	:	5400 LAUREL SPRINGS PKWY
Second Line	:	UNIT 602
City	:	SUWANEE
State	:	GA
Zip	:	30024-6056
Country	:	US
Telephone Number	:	770-573-9255
Fax Number	:	770-573-0505

Authorized Official
Title or Position	:	OWNER
Name	:	JAGAN CHILAKAMARRI
Credential	:	MD
Telephone Number	:	770-573-9255

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	08/22/2020

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Directions to “ATLANTA PSYCHIATRIC INSTITUTE ” Practice Location

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