NPI 1174841647

Mariah Wood Thaxton, PA

Practitioner Physician Assistant Milledgeville, GA

Practice location

Address: 821 N Cobb St, Milledgeville, GA 31061-2343
Phone: (478) 457-7128
Mailing address: 1051 Stone Shoals CT, Watkinsville, GA 30677-2774

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 005696 (GA)

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Registry record

NPI: 1174841647
Entity type: Individual
Sex (as registered): Female
NPI issued: 8 May 2010
Record last updated: 8 May 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.