Healthcare Provider Details
I. General information
NPI: 1124312947
Provider Name (Legal Business Name): TENNESSEE EM-I MEDICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2011
Last Update Date: 06/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2835 HIGHWAY 231 N
SHELBYVILLE TN
37160-7327
US
IV. Provider business mailing address
PO BOX 37663
PHILADELPHIA PA
19101
US
V. Phone/Fax
- Phone: 931-685-5433
- Fax:
- Phone: 800-507-8874
- Fax: 727-536-2896
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GREGORY
J.
BYRNE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 214-712-2000