Individual
MR. EDDY TOUSSAINT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
460 NORTHSIDE CHEROKEE BLVD STE 100, CANTON, GA 30115-8017
(770) 292-3490
(770) 721-5615
Mailing address
980 JOHNSON FERRY RD, STE 1040, ATLANTA, GA 30342-1626
(770) 292-3460
(404) 300-2317
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004561
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
505981429B
—
GA
05
—
505981429C
—
GA
05
—
505981429D
—
GA
05
—
505981429E
—
GA
05
—
505981429F
—
GA
05
—
505981429I
—
GA
05
—
505981429J
—
GA
05
—
505981429K
—
GA
Enumeration date
03/20/2006
Last updated
03/13/2018
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