Individual
MS. PHYLECYA YVETTE CHEATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
101 COUNTRY CLUB RD, TROY, AL 36079-3093
(334) 807-0235
(334) 807-0099
Mailing address
101 COUNTRY CLUB RD, TROY, AL 36079-3093
(334) 807-0235
(334) 807-0099
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00019306
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01D0961776
CLEA
AL
01
—
51044674
BLUE CROSS PROVIDER #
AL
Enumeration date
07/13/2006
Last updated
01/23/2019
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