Individual
JEREMY DANIEL MELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
300 TOWER RD NE, SUITE 200, MARIETTA, GA 30060-9404
(770) 427-5717
(770) 427-6744
Mailing address
300 TOWER RD NE, SUITE 200, MARIETTA, GA 30060-9404
(770) 427-5717
(770) 427-6744
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
007238
GA
363AS0400X
Surgical Physician Assistant
Primary
007238
GA
Other
Enumeration date
07/11/2014
Last updated
08/27/2014
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