Aycock, David Wayne

Aycock, David Wayne is an individual health care provider with primary practice located at 115 Habersham Dr , Fayetteville GA 30214. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Aycock, David Wayne can be contacted via phone (770) 461-9944.

Contact Information

Primary practice address
115 Habersham Dr Fayetteville GA 30214
Fax: (770) 461-9779
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY1239 Georgia

Profile Details

NPI number 1346318284
LBN Legal business name Aycock, David Wayne
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346318284 NPPES
Georgia MEDICAID 00440349B
Georgia Other 680015333

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