Individual
MR. BOBBY JOEL TREADWELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4550 COBB PARKWAY NORTH NW, SUITE 309B, ACWORTH, GA 30101-4180
(770) 917-6795
(770) 529-9077
Mailing address
4550 COBB PARKWAY NORTH NW, SUITE 309B, ACWORTH, GA 30101-4180
(770) 917-6795
(770) 529-9077
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5730
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8101943
—
NC
Enumeration date
03/02/2012
Last updated
10/06/2015
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