Tara D Brown, LAT
Individual provider Active NPI Athletic Trainer · Cedartown, GA
NPI 1811076003 · NPPES record last updated Nov 9, 2017
Key facts
- NPI
- 1811076003
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- AT000844 (GA)
- Practice address
- 1567 Rome Hwy
Cedartown, GA 30125-4402 - Phone
- (770) 749-7120
- Fax
- (706) 622-4348
- NPI assigned
- Nov 6, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT000844 | GA | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT000844 | GA | Yes |
Addresses
Primary practice location
1567 Rome Hwy
Cedartown, GA 30125-4402
Mailing address
1567 Rome Hwy
Cedartown, GA 30125-4402
Phone (770) 749-7120
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811076003 | Other | GA | NPI |
Other providers in Cedartown, GA
- Tony Boston
- Bradford Drugstore, Inc.
- Lindsay A Bramlette
- Connie Smith Brown
- Kaylon Brown
- Brown'S Pharmacy
- Myra Bruce
- Michael Bun
- Kenneth W Burnette
- Dawn Burris
All providers in Cedartown, GA · Athletic Trainer in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.