Individual
BOBBY O TACKITT II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
699 CHURCH ST NE, SUITE 300, MARIETTA, GA 30060-1110
(770) 422-8700
(770) 425-7601
Mailing address
699 CHURCH ST NE, SUITE 300, MARIETTA, GA 30060-1110
(770) 422-8700
(770) 425-7601
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
47267
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00824249A
—
GA
Enumeration date
05/12/2006
Last updated
01/14/2014
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