Individual
MADELINE TULLY URWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
55 WHITCHER ST NE STE 160, MARIETTA, GA 30060-1160
(770) 428-0462
(770) 427-8001
Mailing address
609 VIRGINIA AVE NE APT 2405, ATLANTA, GA 30306-3751
(770) 688-5404
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10894
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1192347
NCCPA ID NUMBER
GA
Enumeration date
02/28/2022
Last updated
10/07/2025
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