Provider Demographics
NPI:1083310007
Name:DYAR, MADISON KATE (PA-C)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:KATE
Last Name:DYAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 26194
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-2012
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:865-381-1509
Practice Address - Street 1:10689 HARDIN VALLEY RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-1504
Practice Address - Country:US
Practice Address - Phone:865-692-1220
Practice Address - Fax:833-908-2093
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN5408363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant