Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Trident Primary Care & Wellness Clinic LLC

Organization Family Medicine Physician · NPI 1760262463

Trident Primary Care & Wellness Clinic LLC is a Family Medicine Physician in Roswell, Georgia. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

875 Old Roswell Rd Bldg C Ste C-200
Roswell, GA 30076-1659
Phone: (678) 731-7000
Fax: (678) 731-7005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1760262463
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Roderick Malone — Managing Member · (678) 478-8077
NPI enumeratedOctober 2, 2023
Last updated in NPPESFebruary 7, 2024
Certification dateFebruary 7, 2024
Mailing address6503 Grand Hickory Dr, Braselton, GA 30517-6240

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