Healthcare Provider Details

I. General information

NPI: 1164742300
Provider Name (Legal Business Name): TENNESSEE EM-I MEDICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 06/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 W BADDOUR PKWY
LEBANON TN
37087-2513
US

IV. Provider business mailing address

PO BOX 37804
PHILADELPHIA PA
19101-0104
US

V. Phone/Fax

Practice location:
  • Phone: 615-444-8262
  • Fax:
Mailing address:
  • Phone: 800-507-8874
  • Fax: 727-536-2896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. GREGORY J. BYRNE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 214-712-2000