MEDICARE: MR. BOBBY JOEL TREADWELL JR. PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	5730	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033483458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BOBBY JOEL TREADWELL JR. PA-C

Provider Business Mailing Address
First Line	:	4550 COBB PARKWAY NORTH NW
Second Line	:	SUITE 309B
City	:	ACWORTH
State	:	GA
Zip	:	30101-4180
Country	:	US
Telephone Number	:	770-917-6795
Fax Number	:	770-529-9077

Provider Business Practice Location Address
First Line	:	4550 COBB PARKWAY NORTH NW
Second Line	:	SUITE 309B
City	:	ACWORTH
State	:	GA
Zip	:	30101-4180
Country	:	US
Telephone Number	:	770-917-6795
Fax Number	:	770-529-9077

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2012
Last Update Date	:	10/06/2015

Similar Medicare Providers

1255296976 — EMILY FOWLER
Practice Location Address:

4550 COBB PARKWAY NORTH NW
ACWORTH, GA
30101-4180

Practice Phone: 470-956-0050
Practice Fax:

1629133103 — DR. OSAGIE OSARUME OKUNDAYE MD
Practice Location Address:

4550 COBB PARKWAY NORTH NW , SUITE 213
ACWORTH, GA
30101-4180

Practice Phone: 770-974-8479
Practice Fax: 770-974-8710

1689796963 — MS. WENDY FOTOPOULOS MA
Practice Location Address:

4550 COBB PARKWAY NORTH NW
ACWORTH, GA
30101-4180

Practice Phone: 770-505-7190
Practice Fax: 770-793-7413

1962680991 — DANIEL JUDAH HOLTZ MD
Practice Location Address:

4550 COBB PARKWAY NORTH NW , SUITE #309B
ACWORTH, GA
30101-4180

Practice Phone: 770-917-6795
Practice Fax: 770-529-9077

1942506654 — WELLSTAR MEDICAL GROUP, LLC
Practice Location Address:

4550 COBB PARKWAY NORTH NW , SUITE 201
ACWORTH, GA
30101-4180

Practice Phone: 770-974-4655
Practice Fax: 770-974-7534

1326333907 — WELLSTAR MEDICAL GROUP, LLC
Practice Location Address:

4550 COBB PARKWAY NW , SUITE 309-B
ACWORTH, GA
30101-4180

Practice Phone: 770-917-6795
Practice Fax: 770-529-9077

Directions to “ MR. BOBBY JOEL TREADWELL JR. PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.