Healthcare Provider Details

I. General information

NPI: 1780609008
Provider Name (Legal Business Name): MARC ESKIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 10/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1068 CRESTHAVEN RD SUITE 150
MEMPHIS TN
38119-0800
US

IV. Provider business mailing address

PO BOX 171181
MEMPHIS TN
38187-1181
US

V. Phone/Fax

Practice location:
  • Phone: 901-682-6828
  • Fax:
Mailing address:
  • Phone: 901-682-2872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD01266
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: