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General NPI Number Information
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NPI Number | 1801009089
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Entity Type | Individual
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Provider Name | JAMES ERIC GARDNER MD
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Gender | Male
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 06/03/2015
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Provider Practice Location Address
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Address Line | 1750 MADISON AVE SUITE 300
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City | MEMPHIS
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State | TN
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Zip | 38104-6492
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Country | US
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Telephone | 901-861-8088
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Fax | 901-861-8082
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Provider Business Mailing Address
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Address Line | PO BOX 38238
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City | GERMANTOWN
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State | TN
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Zip | 38183-0238
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Country | US
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Telephone | 901-861-8088
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Fax | 901-861-8082
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 35417
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License Number State | TN
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