Healthcare Provider Details

I. General information

NPI: 1922212067
Provider Name (Legal Business Name): FIRSTCARE MEDICAL CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 W UNIVERSITY PKWY SUITE A & B
JACKSON TN
38305-1624
US

IV. Provider business mailing address

PO BOX 1798 DEPT 07-031
MEMPHIS TN
38101
US

V. Phone/Fax

Practice location:
  • Phone: 731-512-0043
  • Fax: 731-512-0015
Mailing address:
  • Phone: 731-512-0043
  • Fax: 731-512-0015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EMMANUEL I OBI
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 731-772-3442