| Doctor Name: | TABITHA SUE MELVIN |
| NPI Number: | 1376513564 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 50001977 |
| Business Practice Address: | 1510 Columbus Ave Ste 230 Washington Court House, OH - 431601987 |
| Business Phone Number: | 7403333333 |
| Business Fax Number: | 7403335171 |
| Mailing Address: | 1450 Columbus Ave Ste 104, WASHINGTON COURT HOUSE |
| State: | OH |
| Postal Code: | 431603701 |
| Phone Number: | 7403332236 |
| Fax Number: | 7403333881 |
| NPI Enumeration Date: | 01/23/2006 |
| NPI Last Update Date: | 10/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 50001977 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |