Provider Demographics
NPI:1932320702
Name:MCPHERSON, CAMILLE AIDAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CAMILLE
Middle Name:AIDAN
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 WILLOW RDG
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-7618
Mailing Address - Country:US
Mailing Address - Phone:706-621-9317
Mailing Address - Fax:
Practice Address - Street 1:1181 LANGFORD DR
Practice Address - Street 2:BLDG 300-101
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7242
Practice Address - Country:US
Practice Address - Phone:706-227-8999
Practice Address - Fax:706-227-6118
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218349207V00000X
GA059003207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology