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General NPI Number Information
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NPI Number | 1104059765
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Entity Type | Individual
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Provider Name | PRESTON PARKER EMBREY PA
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Gender | Male
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Dates
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Enumeration Date | 08/31/2009
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 270 E COURT AVE
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City | SELMER
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State | TN
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Zip | 38375-2304
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Country | US
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Telephone | 731-541-9490
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Fax |
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Provider Business Mailing Address
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Address Line | 257 BANCORP SOUTH PKWY # TN38305
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City | JACKSON
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State | TN
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Zip | 38305-7582
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Country | US
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Telephone | 731-660-8759
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Fax | 731-660-8739
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 1768
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1768
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License Number State | TN
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