Provider Demographics
NPI:1194564864
Name:ADVANCED PSYCHIATRY PLLC
Entity type:Organization
Organization Name:ADVANCED PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-900-3505
Mailing Address - Street 1:2241 N MONROE ST # 1232
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-4731
Mailing Address - Country:US
Mailing Address - Phone:603-661-0340
Mailing Address - Fax:
Practice Address - Street 1:1621 METROPOLITAN BLVD STE 202
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-1517
Practice Address - Country:US
Practice Address - Phone:850-900-3505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty