Basic Information
| Provider Information | |||||||||
| NPI: | 1962518985 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FINN | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | ADAM | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 105 S WILLOW AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | COOKEVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 385013138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9313727716 | ||||||||
| FaxNumber: | 9315251066 | ||||||||
| Practice Location | |||||||||
| Address1: | 105 S WILLOW AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | COOKEVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 385013138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9313727716 | ||||||||
| FaxNumber: | 9315251066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2006 | ||||||||
| LastUpdateDate: | 04/06/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 1194 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.