Provider Demographics
NPI:1639124993
Name:MAGEE, MAGDALENE JO (PA)
Entity Type:Individual
Prefix:
First Name:MAGDALENE
Middle Name:JO
Last Name:MAGEE
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1431 CENTERPOINT BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-1984
Mailing Address - Country:US
Mailing Address - Phone:865-985-7049
Mailing Address - Fax:865-291-3228
Practice Address - Street 1:501 REDMOND RD NW
Practice Address - Street 2:ANESTHESIOLOGY DEPARTMENT
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1415
Practice Address - Country:US
Practice Address - Phone:706-368-8022
Practice Address - Fax:706-368-8452
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2014-05-01
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Provider Licenses
StateLicense IDTaxonomies
GA004379367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00244914OtherRAILROAD MEDICARE
GA139553290BMedicaid
GA139553290CMedicaid
GA139553290BMedicaid