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General NPI Number Information
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NPI Number | 1740879428
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Entity Type | Individual
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Provider Name | MADISON TRUMAN PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/15/2021
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 420 W MORRIS BLVD STE 400D
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City | MORRISTOWN
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State | TN
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Zip | 37813-2282
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Country | US
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Telephone | 423-586-7509
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Fax | 423-581-5701
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Provider Business Mailing Address
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Address Line | 104 STURBRIDGE LN
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City | CHURCH HILL
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State | TN
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Zip | 37642-4700
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Country | US
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Telephone | 423-765-8344
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110007619
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4349
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License Number State | TN
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