Provider Demographics
NPI:1154493344
Name:CATHEY, MELINDA BETH (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MELINDA
Middle Name:BETH
Last Name:CATHEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 SPARTA HWY
Mailing Address - Street 2:P O BOX 4608
Mailing Address - City:EATONTON
Mailing Address - State:GA
Mailing Address - Zip Code:31024-8492
Mailing Address - Country:US
Mailing Address - Phone:706-485-8495
Mailing Address - Fax:706-485-7541
Practice Address - Street 1:132 SPARTA HWY
Practice Address - Street 2:
Practice Address - City:EATONTON
Practice Address - State:GA
Practice Address - Zip Code:31024-8492
Practice Address - Country:US
Practice Address - Phone:706-485-8495
Practice Address - Fax:706-485-7541
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004921363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical