Healthcare Provider Details

I. General information

NPI: 1013066596
Provider Name (Legal Business Name): BAPTIST MEMORIAL HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 03/21/2022
Certification Date: 03/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2670 UNION EXTENDED SUITE 610
MEMPHIS TN
38112
US

IV. Provider business mailing address

2670 UNION EXTENDED SUITE 610
MEMPHIS TN
38112
US

V. Phone/Fax

Practice location:
  • Phone: 901-458-4000
  • Fax: 901-458-0048
Mailing address:
  • Phone: 901-458-4000
  • Fax: 901-458-0048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: GREGORY M DUCKETT
Title or Position: SR VP/CLO
Credential:
Phone: 901-227-5233