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General NPI Number Information
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NPI Number | 1780906560
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Entity Type | Organization
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Legal Business Name | TENNESSEE EM-I MEDICAL SERVICES, PC
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 11/01/2010
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Provider Practice Location Address
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Address Line | 367 HOSPITAL BLVD
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City | JACKSON
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State | TN
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Zip | 38305-2080
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Country | US
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Telephone | 731-661-2000
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Fax | 800-305-3233
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Provider Business Mailing Address
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Address Line | 815 S PALAFOX ST SUITE 300
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City | PENSACOLA
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State | FL
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Zip | 32502-5960
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Country | US
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Telephone | 800-444-7009
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Fax | 800-305-3233
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Authorized Official
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Title or Position | PRESIDENT
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Name | GREGORY J BYRNE
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Credential | M.D.
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Telephone | 800-444-7009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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