Provider Demographics
NPI:1073298519
Name:PHILPOT, ELVIN JAKAR
Entity type:Individual
Prefix:
First Name:ELVIN
Middle Name:JAKAR
Last Name:PHILPOT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 CHASTAIN DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4175
Mailing Address - Country:US
Mailing Address - Phone:404-900-8617
Mailing Address - Fax:
Practice Address - Street 1:960 N POINT PKWY STE 450
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-9021
Practice Address - Country:US
Practice Address - Phone:470-300-7585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician