Basic Information
| Provider Information | |||||||||
| NPI: | 1043288400 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JUZANG | ||||||||
| FirstName: | TRINA | ||||||||
| MiddleName: | KAY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 465686 | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300425686 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7702371561 | ||||||||
| FaxNumber: | 7702371124 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 HOSPITAL RD | ||||||||
| Address2: | ANESTHESIA DEPT | ||||||||
| City: | CANTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301142408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048516500 | ||||||||
| FaxNumber: | 7702371124 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 042302 | GA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.