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General NPI Number Information
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NPI Number | 1205836566
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Entity Type | Individual
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Provider Name | TASHA J FORD MD
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Gender | Female
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 05/13/2016
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Provider Practice Location Address
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Address Line | 877 JEFFERSON AVE
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City | MEMPHIS
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State | TN
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Zip | 38103-2807
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Country | US
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Telephone | 901-545-8699
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Fax | 901-545-8998
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Provider Business Mailing Address
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Address Line | 842 JEFFERSON AVE SUITE A645
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City | MEMPHIS
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State | TN
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Zip | 38103-2808
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Country | US
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Telephone | 901-545-8699
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Fax | 901-545-8998
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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 | 207PP0204X
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Taxonomy Name | Pediatric Emergency Medicine (Emergency Medicine) Physician
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License Number | 31431
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 31431
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License Number State | TN
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