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General NPI Number Information
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NPI Number | 1558171967
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Entity Type | Individual
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Provider Name | MADLYN CLAWSON
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Gender | Female
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 958 JOE FRANK HARRIS PKWY SE STE 102A
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City | CARTERSVILLE
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State | GA
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Zip | 30120-2158
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Country | US
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Telephone | 770-386-4824
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Fax | 770-386-4220
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Provider Business Mailing Address
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Address Line | 958 JOE FRANK HARRIS PKWY SE STE 102A
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City | CARTERSVILLE
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State | GA
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Zip | 30120-2158
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Country | US
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Telephone | 770-386-4824
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Fax | 770-386-4220
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 180537
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License Number State | GA
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