Individual
YVONNE MCMAHON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
345 W BROAD ST, COOKEVILLE, TN 38501-2331
(931) 528-1485
Mailing address
425 S MAPLE AVE, COOKEVILLE, TN 38501-3582
(931) 528-0095
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD0000017671
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3054756
—
TN
01
—
4100509
BLUE CROSS-BLUE SHIELD
TN
Enumeration date
04/18/2006
Last updated
07/08/2007
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