Provider Demographics
NPI:1962518985
Name:FINN, MATTHEW ADAM (PA-C)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:ADAM
Last Name:FINN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:105 S WILLOW AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-3138
Mailing Address - Country:US
Mailing Address - Phone:931-372-7716
Mailing Address - Fax:931-525-1066
Practice Address - Street 1:105 S WILLOW AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3138
Practice Address - Country:US
Practice Address - Phone:931-372-7716
Practice Address - Fax:931-525-1066
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1194363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3667428Medicare ID - Type Unspecified
TNQ33125Medicare UPIN