DR. TRACEY LYNN ST.JULIAN (NPI# 1306901467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306901467 |
| Entity Type | Individual |
| Full Name | DR. TRACEY LYNN ST.JULIAN |
| Other Name | TRACEY LYNN FISHER |
| Credential | M.D. |
| Practice Address |
237 Upper Riverdale Rd Sw Riverdale GA 30274-2537 |
| Mailing Address |
970 Winged Foot Trl Fayetteville GA 30215-7829 |
| Practice Telephone | 7709095003 |
| Practice Fax Number | 7709095004 |
| Mailing Telephone | 7707169282 |
| Mailing Fax Number | 7701769282 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-03-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 054127 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 547811054A | 05 |
| Street Address |
237 UPPER RIVERDALE RD SW |
| City | RIVERDALE |
| State | GA |
| Zip Code | 30274-2537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487134474 | Ariana Thompson | Nurse Practitioner | 237 Upper Riverdale Rd Sw, Riverdale, GA 30274-2537 | 2018-08-18 |
| 1821596099 | Anna Pestine | Advanced Practice Midwife | 237 Upper Riverdale Rd Sw, Riverdale, GA 30274-2537 | 2018-01-23 |
| 1437444122 | Jeshenna Jamill Watkins | Obstetrics & Gynecology | 237 Upper Riverdale Rd Sw, Riverdale, GA 30274-2537 | 2011-06-10 |
| 1174852925 | Dawn Janelle Jones | Obstetrics & Gynecology | 237 Upper Riverdale Rd Sw, Riverdale, GA 30274-2537 | 2009-12-08 |
| 1093040644 | Alpha and Omega Dialysis | Clinic/Center | 237 Upper Riverdale Rd Sw, Riverdale, GA 30274-2537 | 2009-10-14 |
| 1083819429 | Premier Womens Obgyn, LLC | Obstetrics & Gynecology | 237 Upper Riverdale Rd Sw, Riverdale, GA 30274-2537 | 2007-06-17 |
| 1821127853 | Katz, Gladstone & Rabin 2 LLC | Obstetrics & Gynecology | 237 Upper Riverdale Rd Sw, Riverdale, GA 30274-2537 | 2007-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862507 | Todd L. Reed | Chiropractor | 83 Upper Riverdale Rd, Riverdale, GA 30274 | 2020-02-05 |
| 1487135992 | Freddie L Sallette IIi | Technician, Pathology | 385 Brookview Dr, Riverdale, GA 30274 | 2018-08-22 |
| 1366933210 | Dawn A. Paul | Nurse Practitioner | 238 Professional Ct Ste A, Riverdale, GA 30274 | 2018-05-27 |
| 1851894588 | Absolute Health Family & Urgent Care Clinic | Clinic/Center | 7574 Ga 85, Riverdale, GA 30274 | 2018-03-08 |
| 1366972127 | Jamillah Ingram | Physical Therapy Assistant | 315 Upper Riverdale Rd., Riverdale, GA 30274 | 2017-06-14 |
| 1114456514 | Grace L Kelson | Licensed Practical Nurse | 9142 Clubhouse Dr, Riverdale, GA 30274 | 2017-06-08 |
| 1790167799 | Cristian Carbuccia | Internal Medicine | 33 Upper Riverdale Rd Sw Ste 10, Riverdale, GA 30274 | 2015-06-25 |
| 1265857692 | Right Choice Enterprises LLC | Technician | 638 Sterling Ct, Riverdale, GA 30274 | 2014-02-21 |
| 1942571625 | Lowes Guardian Angel LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7056 Eunice Dr., Riverdale, GA 30274 | 2012-01-26 |
| 1508134156 | Education System Management, Inc | Social Worker | 125 Highway 138, Riverdale, GA 30274 | 2011-12-12 |
| Find all providers in zip 30274 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144496605 | Life Cycle Ob/gyn, LLC | Obstetrics & Gynecology | 107b Upper Riverdale Rd Sw, Riverdale, GA 30274-2540 | 2008-05-05 |
| 1811187388 | Chelsee Lynn Whitling | Obstetrics & Gynecology | 81 Upper Riverdale Road, Suite 210, Riverdale, GA 30274 | 2007-07-30 |
| 1275617078 | Clifton G Youngblood | Obstetrics & Gynecology | 81 Upper Riverdale Rd, Suite 210, Riverdale, GA 30274-2627 | 2006-10-25 |
| 1912933243 | Tanya Michelle Meziere | Obstetrics & Gynecology | 81 Upper Riverdale Rd Sw, Suite 210, Riverdale, GA 30274-2634 | 2006-06-26 |
| 1255392346 | Timothy Bonitto Brown | Obstetrics & Gynecology | 83 Upper Riverdale Road, Suite 135, Riverdale, GA 30274 | 2006-03-29 |
| 1437444122 | Jeshenna Jamill Watkins | Obstetrics & Gynecology | 237 Upper Riverdale Rd Sw, Riverdale, GA 30274-2537 | 2011-06-10 |
| 1174852925 | Dawn Janelle Jones | Obstetrics & Gynecology | 237 Upper Riverdale Rd Sw, Riverdale, GA 30274-2537 | 2009-12-08 |
| 1790011385 | North Jersey Gynecology PC | Obstetrics & Gynecology | 51 Route 23 South, 1st Floor, Riverdale, NJ 07457 | 2009-11-02 |
| 1083819429 | Premier Womens Obgyn, LLC | Obstetrics & Gynecology | 237 Upper Riverdale Rd Sw, Riverdale, GA 30274-2537 | 2007-06-17 |
| 1821127853 | Katz, Gladstone & Rabin 2 LLC | Obstetrics & Gynecology | 237 Upper Riverdale Rd Sw, Riverdale, GA 30274-2537 | 2007-03-05 |
| Find all providers in RIVERDALE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.