Individual
DR. MICHELLE GRACE PUZDRAKIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1700 WOODLAWN AVE, DYERSBURG, TN 38024-2028
(731) 287-4500
(731) 287-4804
Mailing address
1804 HIGHWAY 45 BYP STE 604, JACKSON, TN 38305-4403
(731) 660-7971
(731) 660-8739
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
308800
LA
208000000X
Pediatrics Physician
42447
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510509
—
TN
Enumeration date
11/23/2005
Last updated
07/21/2022
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