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Individual

MRS. ALEXA MARIE THOMAS DECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4360 CHAMBLEE DUNWOODY RD STE 260, ATLANTA, GA 30341-1055
(877) 231-3376
Mailing address
2505 HARRISON AVE, PANAMA CITY, FL 32405-4464
(850) 233-3376

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9519
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9519
GA
GA
Enumeration date
12/16/2019
Last updated
10/02/2020
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