Healthcare Provider Details

I. General information

NPI: 1144463431
Provider Name (Legal Business Name): JONATHAN TYLER ENGLISH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2009
Last Update Date: 03/09/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 STONEWALL ST
MEMPHIS TN
38112-5115
US

IV. Provider business mailing address

407 STONEWALL ST
MEMPHIS TN
38112-5115
US

V. Phone/Fax

Practice location:
  • Phone: 901-278-6963
  • Fax: 901-274-5224
Mailing address:
  • Phone: 901-581-6087
  • Fax: 901-274-5224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number46447
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number46447
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: