Individual
CASEY L. MAIDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
877 JEFFERSON AVE, MEMPHIS, TN 38103-2807
(901) 545-7100
(901) 448-8472
Mailing address
PO BOX 909, LOUISVILLE, KY 40201
(502) 588-0329
(502) 588-0326
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10001806A
IN
363A00000X
Physician Assistant
Primary
5540
TN
363A00000X
Physician Assistant
TC589
KY
363A00000X
Physician Assistant
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
401531911B
—
GA
Enumeration date
10/09/2008
Last updated
06/12/2024
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