Provider Demographics
NPI:1891160016
Name:MEDLIN, ANTHONY TY (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:TY
Last Name:MEDLIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:303 E WOOD ST
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-3020
Mailing Address - Country:US
Mailing Address - Phone:864-208-8800
Mailing Address - Fax:864-208-0318
Practice Address - Street 1:303 E WOOD ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3020
Practice Address - Country:US
Practice Address - Phone:864-208-8800
Practice Address - Fax:864-208-0318
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2023-09-25
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant