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STAG SHADDUCK
Physician Assistant
NPI: 1962093674IndividualAccepts Medicare
Specialties, Licenses & Credentials
Physician AssistantPrimary
Physician Assistant
Code: 363A00000X
TC072(KY)
CMS Specialties
PrimaryPHYSICIAN ASSISTANT
Education
OTHER
Class of 2021
Contact & Hours
- Address
- 560 S LOOP RD
EDGEWOOD, KY 41017 - Phone
- (859) 301-2663
Quick Facts
- NPI
- 1962093674
- Entity Type
- Individual
- Gender
- Male
- Medicare
- Accepted
- Specialties
- 1
- Locations
- 1
- Years in Practice
- 5
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