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Individual

MRS. GEORGIA STANDKE MANSOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C

Contact information

Practice address
3601 THE VANDERBILT CLINIC, NASHVILLE, TN 37232-5100
(615) 322-3000
Mailing address
3525 W END AVE APT 3B, NASHVILLE, TN 37205-2455
(318) 393-2856

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3035
TN
363AS0400X
Surgical Physician Assistant
7081
GA

Other

Enumeration date
01/16/2014
Last updated
09/16/2016
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