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NPI Code Detail

MEDICARE: EAST MEMPHIS URGENT MEDICAL CLINIC PC

MEDICARE: EAST MEMPHIS URGENT MEDICAL CLINIC PC
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
1261Q00000XClinic/Center
2207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1326670555
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAST MEMPHIS URGENT MEDICAL CLINIC PC
Provider Business Mailing Address
First Line : 6515 POPLAR AVE STE 106
Second Line :
City : MEMPHIS
State : TN
Zip : 38119-4878
Country : US
Telephone Number : 901-762-0700
Fax Number : 901-779-3849
Provider Business Practice Location Address
First Line : 6515 POPLAR AVE STE 106
Second Line :
City : MEMPHIS
State : TN
Zip : 38119-4878
Country : US
Telephone Number : 901-792-0700
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DALE W NORRIS
Credential : MD
Telephone Number : 901-762-0700
Provider Enumeration Date : 02/05/2020
Last Update Date : 03/11/2020

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Directions to “EAST MEMPHIS URGENT MEDICAL CLINIC PC ” Practice Location

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