TALLULAH TRAIL MEDICAL ASSOCIATES, LLC (NPI# 1720426075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720426075 |
| Entity Type | Organization |
| Organization Name | TALLULAH TRAIL MEDICAL ASSOCIATES, LLC |
| Other Organization Name | TALLULAH TRAIL MEDICAL ASSOCIATES |
| Practice Address |
644 Tallulah Trl Warner Robins GA 31088-7625 |
| Practice Telephone | 4783025270 |
| Mailing Telephone | 4783025270 |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2013-06-10 |
| Authorized Official Name | MR. NORMAN W KING (PRESIDENT) |
| Authorized Official Telephone | 4783025270 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Tallulah Trail Medical Associates | Doing Business As Name - Organization |
| Street Address |
644 TALLULAH TRL |
| City | WARNER ROBINS |
| State | GA |
| Zip Code | 31088-7625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093758294 | Ralph Austin Jr. | Family Medicine | 644 Tallulah Trl, Warner Robins, GA 31088-7625 | 2006-06-14 |
| 1407457401 | Chanuki Wanniarachchi Kankanmge | Behavioral Analyst | 644 Tallulah Trl, Warner Robins, GA 31088-7625 | 2020-11-05 |
| 1639770167 | Reyna Behavior Garcia | Behavioral Analyst | 644 Tallulah Trl, Warner Robins, GA 31088-7625 | 2020-11-02 |
| 1942809223 | Auscia Williams | Behavioral Analyst | 644 Tallulah Trl, Warner Robins, GA 31088-7625 | 2020-10-19 |
| 1821697145 | Hannah Albritton | Behavioral Analyst | 644 Tallulah Trl, Warner Robins, GA 31088-7625 | 2020-10-19 |
| 1366041691 | Abigail Ingram | Behavioral Analyst | 644 Tallulah Trl, Warner Robins, GA 31088-7625 | 2020-10-19 |
| 1245839562 | Ashley Cabello | Behavioral Analyst | 644 Tallulah Trl, Warner Robins, GA 31088-7625 | 2020-10-19 |
| 1780283036 | Marcus Mcclain | Behavioral Analyst | 644 Tallulah Trl, Warner Robins, GA 31088-7625 | 2020-10-19 |
| 1023617354 | Cecilia Zavala-arevalo | Behavioral Analyst | 644 Tallulah Trl, Warner Robins, GA 31088-7625 | 2020-10-19 |
| 1003415340 | Laurel Savelli | Behavioral Analyst | 644 Tallulah Trl, Warner Robins, GA 31088-7625 | 2020-10-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982218921 | Sarah Newman | Pharmacist | 1081 Ga-96, Warner Robins, GA 31088 | 2020-09-08 |
| 1619599115 | Alana Jane Sibley | Registered Nurse | 940 Ga - 96, Warner Robins, GA 31088 | 2020-05-07 |
| 1033779657 | Jodi Lynne Pettygrove | Nurse Practitioner | 115 Havelock Cir, Warner Robins, GA 31088 | 2019-06-17 |
| 1164994901 | Gwendolyn Jordan Taylor | Registered Nurse | 940-c Ga Hwy 96, Same, Warner Robins, GA 31088 | 2018-12-18 |
| 1447721543 | Amy Tanner | Behavioral Analyst | 200 Cresview Church Rd #1806, Warner Robins, GA 31088 | 2018-12-16 |
| 1518435676 | Phoenix Health Center | Case Management | 940 Ga-96, Warner Robins, GA 31088 | 2018-11-07 |
| 1427534320 | Jared Dean Johnson | Social Worker | 146 Lakepointe Drive, Warner Robins, GA 31088 | 2018-07-13 |
| 1285124180 | Cmp Academy & Billing Service | Contractor | 105 S Commercial Circle, Warner Robins, GA 31088 | 2018-05-16 |
| 1730692377 | Benzer Pharmacy | Pharmacy | 150 S Houston Lake Rd Ste 300, Warner Robins, GA 31088 | 2017-11-06 |
| 1821507476 | Timothy Doyle Thomas | Registered Nurse | 940-c Hwy 96, Warner Robins, GA 31088 | 2017-09-27 |
| Find all providers in zip 31088 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568087021 | Primary Care & Geriatrics Associates of Central Georgia, L.l.c | Internal Medicine | 1743 Watson Blvd Ste B, Warner Robins, GA 31093-3622 | 2020-06-10 |
| 1528370368 | Sumit Narula | Internal Medicine | 200 Crestview Church Rd Apt 1704, Warner Robins, GA 31088-3171 | 2010-07-09 |
| 1083852537 | Daniel Oliver Fussell | Internal Medicine | 1201 Briarcliff Rd., Warner Robins, GA 31088 | 2009-01-21 |
| 1871607226 | Mobolaji O Ogunsakin Sr. | Internal Medicine | 1420 Watson Blvd, Warner Robins, GA 31093-3446 | 2006-08-19 |
| 1619990033 | Alan Gadson Struth | Internal Medicine | 1037 N Houston Rd, Warner Robins, GA 31093-1505 | 2006-07-26 |
| 1457377525 | Thomas H. Williamson | Internal Medicine | 310 Margie Dr, Ste B, Warner Robins, GA 31088-7817 | 2006-07-14 |
| 1780609867 | Rodrigo E Morales | Internal Medicine | 92 Tommy Stalnaker Dr, Warner Robins, GA 31088-9179 | 2006-07-12 |
| 1023043130 | Richard Lyndon Smith Jr. | Internal Medicine | 1260 Russell Pkwy, Warner Robins, GA 31088-5540 | 2006-07-11 |
| 1790720852 | Hariyebbe C Jayaraj | Internal Medicine | 1205 Russell Pkwy, Warner Robins, GA 31088-5538 | 2006-06-20 |
| 1336182567 | Eric J. Zanghi | Internal Medicine | 1719 Russellpkwy, Bldg 700, Warner Robins, GA 31088 | 2006-06-14 |
| Find all providers in WARNER ROBINS | ||||
| City | WARNER ROBINS |
| Zip Code | 31088 |
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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.