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NPI Code Detail

MEDICARE: JAMES H. BIRD LCSW JAMES BIRD

MEDICARE:   JAMES H. BIRD LCSW  JAMES BIRD
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
11041C0700XClinical Social Worker000113GA

General Provider Information

NPI Number : 1811020589
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES H. BIRD LCSW JAMES BIRD
Provider Business Mailing Address
First Line : 3086 PEACHTREE DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30305-2754
Country : US
Telephone Number : 404-262-1819
Fax Number : 404-262-1819
Provider Business Practice Location Address
First Line : 3086 PEACHTREE DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30305-2754
Country : US
Telephone Number : 404-262-1819
Fax Number : 404-262-1819
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2007
Last Update Date : 07/08/2007

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