Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Mary M Domville, PA

Individual provider Medical Physician Assistant · NPI 1578573820

Mrs. Mary M Domville, PA is a Medical Physician Assistant in Carrollton, Georgia. Licensed in Georgia. Registered with an NPI since 2006.

Licensed in
GA
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

524 Dixie St
Carrollton, GA 30117-3805
Phone: (770) 832-2775
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 003494 (GA)

Record details

NPI number1578573820
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 9, 2006
Last updated in NPPESFebruary 13, 2009

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