Healthcare Provider Details

I. General information

NPI: 1326053042
Provider Name (Legal Business Name): TMC TOTAL CARE FAMILY MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8464 ADAIR ST SUITE B
DOUGLASVILLE GA
30134-1877
US

IV. Provider business mailing address

119 AMBULANCE DR SUITE 202
CARROLLTON GA
30117-3857
US

V. Phone/Fax

Practice location:
  • Phone: 770-942-1044
  • Fax: 770-942-1699
Mailing address:
  • Phone:
  • Fax: 770-838-8922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DALE DREILING
Title or Position: SENIOR VP
Credential: M.D.
Phone: 770-838-8038