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General NPI Number Information
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NPI Number | 1295890358
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Entity Type | Individual
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Provider Name | TRAMMELL STARR III MD
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Gender | Male
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 04/15/2013
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Provider Practice Location Address
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Address Line | 1825 MARTHA BERRY BLVD NW
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City | ROME
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State | GA
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Zip | 30165-1625
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Country | US
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Telephone | 706-295-5331
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Fax | 706-291-8380
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Provider Business Mailing Address
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Address Line | 1825 MARTHA BERRY BLVD NW
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City | ROME
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State | GA
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Zip | 30165-1625
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Country | US
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Telephone | 706-295-5331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 018556
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License Number State | GA
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