=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326154501
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | T GEORGE STOEV MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/21/2006
-----------------------------------------------------
Last Update Date | 11/20/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 526 HALLE PARK DRIVE
-----------------------------------------------------
City | COLLIERVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38017-7085
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-854-1877
-----------------------------------------------------
Fax | 901-854-6181
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 526 HALLE PARK DRIVE
-----------------------------------------------------
City | COLLIERVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38017-7085
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-854-1877
-----------------------------------------------------
Fax | 901-854-6181
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | MD0000029620
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------