Most Relevant Information
Provider Data
| NPI Number: | 1003232265 |
| Provider Name: | BEVERLY JEAN CADWALLADER PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | 8792 |
Most Important Dates
| Enumeration Date: | 03/12/2014 |
| Last Updated: | 02/09/2023 |
Provider Practice Location
1129 LAKE OCONEE PKWY STE 104
EATONTON
GA
310249581
Practice Location Phone/Fax
| Phone: | 7622201962 |
| Fax: | 7622201961 |
Provider Mailing Location
1129 LAKE OCONEE PKWY STE 104
EATONTON
GA
310249581
Provider Mailing Phone/Fax
| Phone: | 7622201962 |
| Fax: | 7622201961 |