Healthcare Provider Details

I. General information

NPI: 1255915286
Provider Name (Legal Business Name): CHOICES MEDICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2021
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N GIANT CITY RD
CARBONDALE IL
62902-6418
US

IV. Provider business mailing address

1203 POPLAR AVE
MEMPHIS TN
38104-7241
US

V. Phone/Fax

Practice location:
  • Phone: 618-300-6017
  • Fax: 618-300-6084
Mailing address:
  • Phone: 901-274-3550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TERRY KEITH GREBE
Title or Position: PRESIDENT
Credential: MD
Phone: 901-791-9386