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General NPI Number Information
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NPI Number | 1215157003
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Entity Type | Organization
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Legal Business Name | JESSE M WESBERRY MD PSC
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 2900 S PERKINS RD
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City | MEMPHIS
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State | TN
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Zip | 38118-3237
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Country | US
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Telephone | 901-362-3100
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Fax | 901-362-3372
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Provider Business Mailing Address
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Address Line | 2900 S PERKINS RD
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City | MEMPHIS
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State | TN
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Zip | 38118-3237
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Country | US
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Telephone | 901-362-3100
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Fax | 901-362-3372
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Authorized Official
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Title or Position | VICE PRESIDENT/OFFICE MANGER
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Name | MRS. MARY LEE WESBERRY
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Credential |
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Telephone | 901-362-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | MD13481
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License Number State | TN
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