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General NPI Number Information
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NPI Number | 1578091682
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Entity Type | Organization
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Legal Business Name | TEAMHEALTH
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Dates
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Enumeration Date | 06/02/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 211 4TH ST
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City | ALEXANDRIA
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State | LA
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Zip | 71301-8421
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Country | US
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Telephone | 318-769-5002
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Fax |
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Provider Business Mailing Address
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Address Line | 428 ANSLEY BLVD APT E
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City | ALEXANDRIA
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State | LA
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Zip | 71303-2286
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Country | US
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Telephone | 404-226-8839
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Fax |
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Authorized Official
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Title or Position | EMERGENCY MEDICINE PHYSICIAN
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Name | DR. CARY RANDALL BYBEE
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Credential | MD
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Telephone | 404-226-8839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD60676012
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License Number State | WA
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