Provider Demographics
NPI:1831484179
Name:DAVIDSON, SAMANTHA LYNN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:LYNN
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:301 TYSON AVE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-4544
Mailing Address - Country:US
Mailing Address - Phone:731-642-1220
Mailing Address - Fax:
Practice Address - Street 1:14201 US-79 N UNIT 4
Practice Address - Street 2:
Practice Address - City:BUCHANAN
Practice Address - State:TN
Practice Address - Zip Code:38222
Practice Address - Country:US
Practice Address - Phone:731-407-7013
Practice Address - Fax:731-407-7019
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant