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General NPI Number Information
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NPI Number | 1285603100
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Entity Type | Organization
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Legal Business Name | MEMPHIS EYE AND CATARACT AMBULATORY SURGERY CENTER INC
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 11/09/2007
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Provider Practice Location Address
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Address Line | 6485 POPLAR AVE
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City | MEMPHIS
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State | TN
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Zip | 38119-4864
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Country | US
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Telephone | 901-767-4014
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Fax | 901-767-1695
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Provider Business Mailing Address
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Address Line | 6485 POPLAR AVE
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City | MEMPHIS
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State | TN
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Zip | 38119-4864
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Country | US
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Telephone | 901-767-4014
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Fax | 901-767-1695
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Authorized Official
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Title or Position | OWNER
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Name | DR. JERRE M FREEMAN
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Credential | MD
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Telephone | 901-767-4014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 0000000045
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License Number State | TN
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