=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851230171
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TWO DOC, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/25/2026
-----------------------------------------------------
Last Update Date | 03/25/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2445 FREEDOM PARKWAY BUILDING A, SUITE 100
-----------------------------------------------------
City | CUMMING
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30041
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 478-796-8234
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1110 MARKET ST STE 502
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37402-3310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-602-9530
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP OF CLINICAL OPS
-----------------------------------------------------
Name | ANN MILLER TALLENT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 423-664-1070
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------