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General NPI Number Information
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NPI Number | 1861579393
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Entity Type | Organization
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Legal Business Name | MEMPHIS AREA PERFUSION (MAP)
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6019 WALNUT GROVE RD
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City | MEMPHIS
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State | TN
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Zip | 38120-2113
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Country | US
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Telephone | 901-226-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 4803 NEW AIRLINE RD
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City | ARLINGTON
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State | TN
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Zip | 38002-9586
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Country | US
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Telephone | 901-867-4867
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Fax | 901-867-0569
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Authorized Official
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Title or Position | PRESEDENT
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Name | GARY BECKMAN
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Credential | CCP, LCP
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Telephone | 901-210-4258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number | CP0000000030
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License Number State | TN
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