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General NPI Number Information
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NPI Number | 1801863857
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Entity Type | Individual
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Provider Name | PAMELA A MIDDLETON M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 2051 CLEVIDENCE BLVD SUITE A
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City | CLARKSVILLE
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State | IN
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Zip | 47129-2278
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Country | US
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Telephone | 812-282-1720
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Fax | 812-280-6636
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Provider Business Mailing Address
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Address Line | PO BOX 776351
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 502-588-9490
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Fax | 502-272-5116
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 01047781A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01047781A
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License Number State | IN
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