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General NPI Number Information
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NPI Number | 1588976351
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Entity Type | Individual
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Provider Name | TRINIDAD D OSSELYN MD
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Gender | Female
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Dates
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Enumeration Date | 07/09/2010
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Last Update Date | 01/10/2022
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Provider Practice Location Address
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Address Line | 1125 TOWN CENTER VILLAGE DR KAISER PERMANENTE HENRY TOWNE CENTRE MEDICAL CENTER
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City | MCDONOUGH
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State | GA
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Zip | 30253-5970
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Country | US
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Telephone | 678-583-6600
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Fax | 770-929-1016
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Provider Business Mailing Address
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Address Line | 3495 PIEDMONT RD NE NINE PIEDMONT CENTER
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City | ATLANTA
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State | GA
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Zip | 30305-1717
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Country | US
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Telephone | 404-504-5678
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Fax | 770-929-1016
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | LL32747
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 069081
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License Number State | GA
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