NPI 1194874628
Maxine a Theriot, MD
Practice location
- Address
- 3098 Oak Grove Rd, Poplar Bluff, MO 63901-8938
- Phone
- (573) 686-8199
- Fax
- (573) 686-8398
- Mailing address
- 709 W Rusk St STE B, Rockwall, TX 75087-3600
Registered specialties (3)
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
Family Medicine Physician
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Registry record
- NPI
- 1194874628
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 10 Jan 2007
- Record last updated
- 13 Jul 2023
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.