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Individual

MRS. DAPHNE TRACY FOUST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
849 VOLUNTEER DR STE 2, PARIS, TN 38242-5483
(731) 540-7075
(731) 227-2887
Mailing address
849 VOLUNTEER DR STE 2, PARIS, TN 38242-5483
(731) 540-7075
(731) 227-2887

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA229
TN
363AS0400X
Surgical Physician Assistant
PA229
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
229
PA LICENSE
TN
01
3380640
MEDICAID GROUP
TN
01
3663231
MEDICAID
TN
Enumeration date
03/02/2006
Last updated
06/16/2023
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