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Organization
VICTOR A. SHADA, D.O., P.C.
Active
Organization
VICTOR A. SHADA, D.O., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR ANTHONY SHADA D.O. (OWNER)
(931) 484-4560
Entity
Organization
Contact information
Practice address
396 S MAIN ST, CROSSVILLE, TN 38555-5092
(931) 484-4560
(931) 484-1480
Mailing address
PO BOX 887, CROSSVILLE, TN 38557-0887
(931) 484-4560
(931) 484-1480
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1424
TN
Other
Enumeration date
11/20/2007
Last updated
07/09/2010
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