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General NPI Number Information
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NPI Number | 1023263852
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Entity Type | Organization
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Legal Business Name | BAYMILLER PSYCHIATRY
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Dates
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Enumeration Date | 11/20/2008
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Last Update Date | 11/20/2008
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Provider Practice Location Address
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Address Line | 622 WEST POPLAR AVENUE SUITE 5, PMB 114
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City | COLLIERVILLE
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State | TN
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Zip | 38017-2578
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Country | US
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Telephone | 901-482-4822
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Fax |
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Provider Business Mailing Address
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Address Line | 622 WEST POPLAR AVE SUITE 5, PMB 114
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City | COLLIERVILLE
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State | TN
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Zip | 38017-2578
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Country | US
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Telephone | 901-482-4822
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTT PATRICK BAYMILLER
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Credential | M.D.
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Telephone | 901-482-4822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 36958
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License Number State | TN
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