Provider Demographics
NPI:1538620604
Name:ASSOCIATES IN INTELLIGENT PSYCHIATRY PLLC
Entity type:Organization
Organization Name:ASSOCIATES IN INTELLIGENT PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-298-1699
Mailing Address - Street 1:7993 BARTONSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:27310-9674
Mailing Address - Country:US
Mailing Address - Phone:336-312-8716
Mailing Address - Fax:
Practice Address - Street 1:806 GREEN VALLEY RD STE 200
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7076
Practice Address - Country:US
Practice Address - Phone:336-298-1699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-29
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty