Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MAXINE A THERIOT, MD
ActiveMAXINE A THERIOT, MD is a 2083P0011X healthcare provider located in POPLAR BLUFF, Missouri. NPI 1194874628 is currently active in the NPPES registry. Verify at CMS.
2083P0011X · POPLAR BLUFF, MO
Registration Details
- NPI Number
- 1194874628
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 10, 2007 (19.600449429497 yrs)
- Last Updated
- Jul 13, 2023
- Licenses
-
J9578 (TX)J9578 (TX)2022047286 (MO)
Practice Information
- Address
-
3098 OAK GROVE RDPOPLAR BLUFF, MO, 639018938Browse MO providers · Browse ZIP 63901
- Phone
- 5736868199
- Fax
- 5736868398
- Primary Specialty
-
2083P0011X
2083P0011X
- Additional Specialty
- 2083P0011X
- Additional Specialty
- 2083P0011X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.