Healthcare Provider Details

I. General information

NPI: 1235293713
Provider Name (Legal Business Name): JAMES A. LOVELL M.ED.,ATC, LAT, EMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 HANK AARON DR SW
ATLANTA GA
30315-1120
US

IV. Provider business mailing address

PO BOX 4064
ATLANTA GA
30302-4064
US

V. Phone/Fax

Practice location:
  • Phone: 404-614-1373
  • Fax: 404-614-1549
Mailing address:
  • Phone: 404-614-1373
  • Fax: 404-614-1549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number9142406
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT000953
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: