Individual
MADISON LEIGH SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
509 SHERIDAN RD, NOBLESVILLE, IN 46060-1317
(317) 678-6402
Mailing address
1867 WATER OAK WAY, AVON, IN 46123-7421
(463) 201-7955
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004406A
IN
Other
Enumeration date
06/06/2024
Last updated
06/06/2024
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