Fred George PH.D,, P.a.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

143 Issued in AL

Legal business name

FRED GEORGE PH.D,, P.A.

Practice address

1275 James Dr
Suite a
Enterprise, AL 36330-2063

Phone

(334) 347-1862

Fax

(334) 347-2919

NPI assigned

Sep 4, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Fred George, PH.D.

Title

Psychologist

Phone

(334) 347-1862

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220486400000",
    "number": "1548418452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 JAMES DR",
            "address_2": "SUITE A",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302063",
            "telephone_number": "334-347-1862",
            "fax_number": "334-347-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 JAMES DR",
            "address_2": "SUITE A",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302063",
            "telephone_number": "334-347-1862",
            "fax_number": "334-347-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED GEORGE PH.D,, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-04",
        "last_updated": "2008-09-04",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "334-347-1862",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AL",
            "license": "143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890001970",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.