Healthcare Provider Details

I. General information

NPI: 1467532705
Provider Name (Legal Business Name): JEFFREY TOWBIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 N DUNLAP ST FL 2
MEMPHIS TN
38105
US

IV. Provider business mailing address

49 N DUNLAP ST FL 3
MEMPHIS TN
38103-2802
US

V. Phone/Fax

Practice location:
  • Phone: 901-287-7337
  • Fax: 901-287-4646
Mailing address:
  • Phone: 901-287-6819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number52598
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: