# VICTOR A. SHADA, D.O., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407037211
- **Authorized official:** DR. VICTOR ANTHONY SHADA D.O. (OWNER)
- **Authorized official phone:** (931) 484-4560

## Contact information

- **Practice address:** 396 S MAIN ST, CROSSVILLE, TN 38555-5092
- **Practice address phone:** (931) 484-4560
- **Practice address fax:** (931) 484-1480
- **Mailing address:** PO BOX 887, CROSSVILLE, TN 38557-0887
- **Mailing address phone:** (931) 484-4560
- **Mailing address fax:** (931) 484-1480

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 1424 | TN | Yes |

## Other

- **Enumeration date:** 11/20/2007
- **Last updated:** 07/09/2010