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Organization

TRINITY PEDIATRIC MEDICINE OF FAYETTEVILLE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAUL MCKOY (CFO)
(678) 517-8368
Entity
Organization

Contact information

Practice address
3695 CASCADE RD SW STE V, ATLANTA, GA 30331-2146
(404) 696-6595
Mailing address
719 LANIER AVE W STE A2, FAYETTEVILLE, GA 30214-7634

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
10/08/2015
Last updated
10/08/2015
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