Mackillop, Emily Jo Anderson

Mackillop, Emily Jo Anderson is an individual health care provider with primary practice located at 2400 Mt. Zion Parkway Kaiser Permanente Southwood Medical Center, Jonesboro GA 30236. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Mackillop, Emily Jo Anderson can be contacted via phone (770) 603-3877.

Contact Information

Primary practice address
2400 Mt. Zion Parkway Kaiser Permanente Southwood Medical Center Jonesboro GA 30236
Phone: (770) 603-3877
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY003221 Georgia

Profile Details

NPI number 1871743328
LBN Legal business name Mackillop, Emily Jo Anderson
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2008
Last updated Jun 28th, 2011 - about 15 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 1871743328 NPPES
Georgia MEDICAID 631220898A

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