Healthcare Provider Details

I. General information

NPI: 1508003096
Provider Name (Legal Business Name): TENNESSEE EM-I MEDICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2009
Last Update Date: 01/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 WHEELERTOWN AVE
PIKEVILLE TN
37367-5246
US

IV. Provider business mailing address

PO BOX 13811
PHILADELPHIA PA
19101-3811
US

V. Phone/Fax

Practice location:
  • Phone: 423-447-2112
  • Fax:
Mailing address:
  • Phone: 727-507-3609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StateTN

VIII. Authorized Official

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