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General NPI Number Information
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NPI Number | 1457797938
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Entity Type | Organization
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Legal Business Name | PERFECT HEALTH ALWAYS ON CALL, LLC
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Dates
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Enumeration Date | 05/11/2013
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Last Update Date | 07/03/2018
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Provider Practice Location Address
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Address Line | 4244 WASHINGTON RD
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City | EVANS
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State | GA
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Zip | 30809
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Country | US
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Telephone | 706-760-7607
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Fax | 706-760-7605
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Provider Business Mailing Address
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Address Line | PO BOX 509
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City | GROVETOWN
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State | GA
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Zip | 30813
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Country | US
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Telephone | 706-760-7607
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Fax | 706-760-7605
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. TROY PAUL COON
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Credential | MD
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Telephone | 762-218-3627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 056422
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 056422
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License Number State | GA
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