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Individual

DR. TRACEY LYNN ST. JULIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
300 GLYNN STREET SOUTH, FAYETTEVILLE, GA 30214
(770) 629-2702
(770) 909-5004
Mailing address
300 GLYNN STREET SOUTH, FAYETTEVILLE, GA 30214
(770) 629-2702
(770) 176-9282

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
054127
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
547811054A
GA
Enumeration date
12/27/2006
Last updated
05/17/2024
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