Provider Demographics
NPI:1215097894
Name:PURVIS, JAMES ALLAN (PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALLAN
Last Name:PURVIS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5907
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30023-5907
Mailing Address - Country:US
Mailing Address - Phone:470-508-8955
Mailing Address - Fax:470-508-8956
Practice Address - Street 1:5807 LONG PARK RD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-5718
Practice Address - Country:US
Practice Address - Phone:470-508-8955
Practice Address - Fax:470-508-8956
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1491103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist