Provider Demographics
NPI:1457602435
Name:MCAFEE, MARVIN TOLBERT III (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MARVIN
Middle Name:TOLBERT
Last Name:MCAFEE
Suffix:III
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 EAST 4TH AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CORDELE
Mailing Address - State:GA
Mailing Address - Zip Code:31015
Mailing Address - Country:US
Mailing Address - Phone:229-273-8501
Mailing Address - Fax:
Practice Address - Street 1:416 EAST 4TH AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CORDELE
Practice Address - State:GA
Practice Address - Zip Code:31015
Practice Address - Country:US
Practice Address - Phone:229-273-8501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6543363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA6543OtherSTATE MEDICAL LICENSE