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General NPI Number Information
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NPI Number | 1104274091
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Entity Type | Organization
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Legal Business Name | TRISTATE OBGYN, PC
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Dates
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Enumeration Date | 06/01/2016
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 3337 KIRBY PKWY
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City | MEMPHIS
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State | TN
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Zip | 38115-3816
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Country | US
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Telephone | 901-590-4428
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Fax | 901-249-5827
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Provider Business Mailing Address
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Address Line | PO BOX 1377 DEPT 800
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City | COLLIERVILLE
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State | TN
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Zip | 38027-1377
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Country | US
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Telephone | 901-590-4428
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Fax | 901-249-5827
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHEN EHIREMEN
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Credential | MD
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Telephone | 901-937-9549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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