Provider Demographics
NPI:1548310246
Name:WILLIAM F DOVERSPIKE PHD PC
Entity type:Organization
Organization Name:WILLIAM F DOVERSPIKE PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:DOVERSPIKE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:770-913-0506
Mailing Address - Street 1:6111 PEACHTREE DUNWOODY ROAD
Mailing Address - Street 2:C
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4522
Mailing Address - Country:US
Mailing Address - Phone:770-913-0506
Mailing Address - Fax:770-399-0007
Practice Address - Street 1:6111 PEACHTREE DUNWOODY ROAD
Practice Address - Street 2:C
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4522
Practice Address - Country:US
Practice Address - Phone:770-913-0506
Practice Address - Fax:770-399-0007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA647103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty