Individual
MRS. MEREDITH STATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
355 CLEAR CREEK PKWY STE 2007, LAVONIA, GA 30553-4271
(706) 356-2934
(706) 356-8037
Mailing address
3320 OLD JEFFERSON RD BLDG 800, ATHENS, GA 30607-1400
(706) 353-2990
(706) 353-2992
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003412
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003412
STATE LISENCE
GA
Enumeration date
03/01/2007
Last updated
07/19/2024
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