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NPI Code Detail

MEDICARE: TRACY PATERSON PA-C

MEDICARE: TRACY PATERSON 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
1363AM0700XMedical Physician Assistant3967GA

General Provider Information

NPI Number : 1669412623
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY PATERSON PA-C
Provider Business Mailing Address
First Line : 859 MOUNT VERNON HWY NE STE 300
Second Line :
City : ATLANTA
State : GA
Zip : 30328-4255
Country : US
Telephone Number : 404-785-0588
Fax Number : 404-785-0596
Provider Business Practice Location Address
First Line : 859 MOUNT VERNON HWY NE STE 300
Second Line :
City : ATLANTA
State : GA
Zip : 30328-4255
Country : US
Telephone Number : 404-785-0588
Fax Number : 404-785-0596
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2006
Last Update Date : 06/06/2022

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Directions to “ TRACY PATERSON PA-C” Practice Location

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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.

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