Provider Demographics
NPI:1922088194
Name:TRAMMELL, DANIEL BOYD (BSPHR MBA)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:BOYD
Last Name:TRAMMELL
Suffix:
Gender:M
Credentials:BSPHR MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2051 KEENELAND DR
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-5920
Mailing Address - Country:US
Mailing Address - Phone:770-725-2775
Mailing Address - Fax:706-549-6838
Practice Address - Street 1:795 OGLETHORPE AVE
Practice Address - Street 2:CVS/CAREMARK #5704
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-4085
Practice Address - Country:US
Practice Address - Phone:706-549-6838
Practice Address - Fax:706-549-6837
Is Sole Proprietor?:No
Enumeration Date:2006-01-22
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA015075183500000X
NC09096183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC09096OtherLICENSE
GA015075OtherLICENSE