Provider Demographics
NPI:1558557165
Name:MISEL, NATHAN P (PA-C)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:P
Last Name:MISEL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:75 HOSPITAL DR STE 250
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2866
Mailing Address - Country:US
Mailing Address - Phone:740-566-4621
Mailing Address - Fax:740-566-4622
Practice Address - Street 1:75 HOSPITAL DR STE 250
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2866
Practice Address - Country:US
Practice Address - Phone:740-566-4621
Practice Address - Fax:740-566-4622
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2012-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH50.002704363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant