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General NPI Number Information
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NPI Number | 1841284445
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Entity Type | Individual
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Provider Name | DARRION JEWAYNE PREWITT MD
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Gender | Male
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Dates
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Enumeration Date | 09/09/2005
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Last Update Date | 04/07/2011
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Provider Practice Location Address
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Address Line | 503 E TICKLE ST SUITE C
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City | DYERSBURG
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State | TN
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Zip | 38024-3165
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Country | US
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Telephone | 731-512-0104
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Fax | 731-512-0601
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Provider Business Mailing Address
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Address Line | 17 CENTRE PLAZA DR SUITE C
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City | JACKSON
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State | TN
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Zip | 38305-2862
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Country | US
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Telephone | 731-512-0104
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Fax | 731-512-0601
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD027357
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License Number State | TN
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