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MEAGEN STURDIVANT MADDOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3493 VETERANS DR N, SUITE C, HUNTINGDON, TN 38344-6227
(731) 986-2933
(731) 986-2938
Mailing address
PO BOX 465, HUNTINGDON, TN 38344-0465
(731) 986-2933
(731) 986-2938

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2167
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q001946
TN
Enumeration date
07/12/2012
Last updated
10/07/2020
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