Provider Demographics
NPI:1356578603
Name:SATCHELL, TIFFANY MELISSA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:MELISSA
Last Name:SATCHELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:393 PLYMSTOCK DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-2920
Mailing Address - Country:US
Mailing Address - Phone:914-830-2335
Mailing Address - Fax:770-957-7006
Practice Address - Street 1:350 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-3838
Practice Address - Country:US
Practice Address - Phone:478-765-4144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-14
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024723363A00000X
GA005145363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant