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General NPI Number Information
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NPI Number | 1881901163
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Entity Type | Organization
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Legal Business Name | JAMES ERIC GARDNER, MD, PC
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 09/08/2010
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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 |
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Provider Business Mailing 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 |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES GARDNER
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Credential | MD
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Telephone | 901-861-8088
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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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