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Contact Information

TRIDENT MEDICAL GROUP PA
3372 PEACHTREE ROAD
SUITE 115
ATLANTA, GA30326
 Phone: 855-770-7771
 Fax: 415-808-6405
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Podiatrist

213E00000X 48 Podiatry
 

Public Health

213EP0504X 48 Podiatry
Indicates primary specialty

NPI Profile & details for TRIDENT MEDICAL GROUP PA

NPI Number 1699435081
LBN Legal business name TRIDENT MEDICAL GROUP PA
Authorized official DEVION SMITH - (DIRECTOR, PAYER CONTRACTING)
Entity Organization
Organization subpart 1 No
Enumeration date 12/27/2021
Last updated 11/14/2022 - About 4 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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