Provider Demographics
NPI:1316936545
Name:CENTER FOR PSYCHIATRIC CARE PC
Entity type:Organization
Organization Name:CENTER FOR PSYCHIATRIC CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:BRANAM
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:478-405-9945
Mailing Address - Street 1:PO BOX 1775
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31202-1775
Mailing Address - Country:US
Mailing Address - Phone:478-405-9945
Mailing Address - Fax:478-405-9951
Practice Address - Street 1:4112 ARKWRIGHT RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-1707
Practice Address - Country:US
Practice Address - Phone:478-405-9945
Practice Address - Fax:478-405-9951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1269Medicare ID - Type Unspecified