Provider Demographics
NPI:1104046366
Name:DOUGLAS E WEBB JR PHD INC
Entity type:Organization
Organization Name:DOUGLAS E WEBB JR PHD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATION PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-257-2722
Mailing Address - Street 1:685 DENSLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-5445
Mailing Address - Country:US
Mailing Address - Phone:404-257-2722
Mailing Address - Fax:404-320-9510
Practice Address - Street 1:2453 NORTH DECATUR ROAD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033
Practice Address - Country:US
Practice Address - Phone:404-257-2722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1600103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty