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NPI Code Detail

MEDICARE: DR. TASHA J FORD MD

MEDICARE: DR. TASHA J FORD MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207PP0204XPediatric Emergency Medicine (Emergency Medicine) Physician31431TN
2207P00000XEmergency Medicine Physician31431TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205836566
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TASHA J FORD MD
Provider Business Mailing Address
First Line : 842 JEFFERSON AVE
Second Line : SUITE A645
City : MEMPHIS
State : TN
Zip : 38103-2808
Country : US
Telephone Number : 901-545-8699
Fax Number : 901-545-8998
Provider Business Practice Location Address
First Line : 877 JEFFERSON AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38103-2807
Country : US
Telephone Number : 901-545-8699
Fax Number : 901-545-8998
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 05/13/2016

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