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NPI 1801396049

NPI 1801396049 : PAXTON KIMBER SISSON P.A. : MC KENZIE, TN

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General NPI Number Information
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    NPI Number           |    1801396049
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    Entity Type          |    Individual 
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    Provider Name        |    PAXTON KIMBER SISSON P.A.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/14/2018
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    Last Update Date     |    11/11/2025
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Provider Practice Location Address
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    Address Line         |    22700 HIGHWAY 22 STE A 
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    City                 |    MC KENZIE
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    State                |    TN
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    Zip                  |    38201-8679
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    Country              |    US
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    Telephone            |    731-986-7200
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    Fax                  |    731-986-7292
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Provider Business Mailing Address
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    Address Line         |    350 N HUMPHREYS BLVD 
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    City                 |    MEMPHIS
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    State                |    TN
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    Zip                  |    38120-2177
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    Country              |    US
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    Telephone            |    901-226-4003
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    Fax                  |    901-227-8591
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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       |    3514
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    License Number State |    TN
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