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General NPI Number Information
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NPI Number | 1346762838
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Entity Type | Organization
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Legal Business Name | PRECISION MEDICAL CENTER PC
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Dates
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Enumeration Date | 07/17/2017
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Last Update Date | 01/15/2020
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Provider Practice Location Address
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Address Line | 4646 N SHALLOWFORD RD STE 555
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City | ATLANTA
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State | GA
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Zip | 30338-6308
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Country | US
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Telephone | 404-290-1029
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Fax |
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Provider Business Mailing Address
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Address Line | 3545 BROAD ST UNIT 81690
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City | ATLANTA
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State | GA
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Zip | 30366-2116
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Country | US
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Telephone | 404-290-1029
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ANTOINE TRAMMELL
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Credential | MD
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Telephone | 770-462-2329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 59779
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License Number State | GA
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