person
Tracy Crockett, PA
Medical Physician Assistant in Athens, Georgia
NPI 1184626996

Tracy Crockett is a Medical Physician Assistant based in Athens, GA and is specialized in Medical. Tracy Crockett practices in Athens, GA and has the professional credentials of PA. The NPI Number for Tracy Crockett is 1184626996 and holds a License No. 1763 (Georgia).

The current practice location address for Tracy Crockett is 2470 Daniels Bridge Rd, Athens, GA and can be reached out via phone at 706-389-3440 and via fax at 706-353-2771.

Location: 2470 Daniels Bridge Rd, Athens, GA, 30605-5350
person
Provider Profile Details
NPI Number
1184626996
Provider Name
Tracy Crockett
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
2470 Daniels Bridge Rd, Athens, GA, 30605-5350
Phone Number
706-389-3440
Fax Number
706-353-2771
Provider Enumeration Date
08/11/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100000351C 05 GA
institution
Provider Business Practice Location Address Details
Address
2470 Daniels Bridge Rd
City
State
Zip
30606-6187
Phone Number
706-389-3440
Fax Number
706-353-2771
person
Provider Business Mailing Address Details
Address
2470 Daniels Bridge Rd
City
State
Zip
30606-6187
Phone Number
706-389-3440
Fax Number
706-353-2771
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
1763 (Georgia)
Definition
Definition to come...
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