TRACY PAVONE

BRUNSWICK, GA
NPI1881730984
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367H00000X Anesthesiologist Assistant
(Licence: GA  2697)
Additional Taxonomies363A00000X Physician Assistant
(Licence: GA  002697)
Enumeration Date2007-01-29
Last Update Date2011-04-13
Business Address
-- TRACY PAVONE AA
3100 KEMBLE AVE
BRUNSWICK, GA 31520-4211
Phone number: 912-264-7000
Mailing Address
-- TRACY PAVONE AA
PO BOX 235019
MONTGOMERY, AL 36123-5019
Phone number: 334-279-1450