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General NPI Number Information
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NPI Number | 1417604042
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Entity Type | Organization
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Legal Business Name | PARAGON MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 03/03/2022
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 5625 POPLAR AVE
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City | MEMPHIS
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State | TN
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Zip | 38119-3816
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Country | US
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Telephone | 844-207-8431
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Fax |
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Provider Business Mailing Address
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Address Line | 5625 POPLAR AVE
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City | MEMPHIS
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State | TN
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Zip | 38119-3816
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Country | US
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Telephone | 844-207-8431
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DAVID EDWARD BUECHNER
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Credential |
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Telephone | 901-413-3618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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