Individual
JIMMY RUSSELL MAUNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1000 S GATEWAY BLVD, CLARKSVILLE, TN 37043-8118
(931) 552-4340
(931) 552-0999
Mailing address
PO BOX 306556, NASHVILLE, TN 37230-6556
(615) 329-2294
(615) 695-1494
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2008
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q006557
—
TN
Enumeration date
12/09/2009
Last updated
07/08/2025
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