MEDICARE: PSYCHIATRIC MEDICINE, P.C.

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		GA

General Provider Information

NPI Number	:	1760609473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSYCHIATRIC MEDICINE, P.C.

Provider Business Mailing Address
First Line	:	4849 PAULSEN ST
Second Line	:	SUITE 201
City	:	SAVANNAH
State	:	GA
Zip	:	31405-4423
Country	:	US
Telephone Number	:	912-354-8108
Fax Number	:	912-354-0139

Provider Business Practice Location Address
First Line	:	4849 PAULSEN ST
Second Line	:	SUITE 201
City	:	SAVANNAH
State	:	GA
Zip	:	31405-4423
Country	:	US
Telephone Number	:	912-354-8108
Fax Number	:	912-354-0139

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL CHARLES MOBLEY
Credential	:	M.D.
Telephone Number	:	912-354-8108

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	08/22/2020

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