Healthcare Provider Details

I. General information

NPI: 1760434930
Provider Name (Legal Business Name): TENNESSEE EM-I MEDICAL SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 02/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E TICKLE ST
DYERSBURG TN
38024-3120
US

IV. Provider business mailing address

815 S PALAFOX ST STE 300
PENSACOLA FL
32502-5937
US

V. Phone/Fax

Practice location:
  • Phone: 731-285-2410
  • Fax: 800-305-3233
Mailing address:
  • Phone: 800-444-7009
  • Fax: 800-305-3233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GREGORY J BYRNE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 800-362-2731