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General NPI Number Information
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NPI Number | 1912579400
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Entity Type | Individual
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Provider Name | JEFFREY T. BARTHOLOMEW NP
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Gender | Male
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Dates
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Enumeration Date | 07/14/2021
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Last Update Date | 07/14/2021
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Provider Practice Location Address
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Address Line | 5865 RIDEWAY CENTER PARKWAY
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City | MEMPHIS
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State | TN
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Zip | 38120-3812
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Country | US
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Telephone | 337-991-9276
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Fax | 337-943-0846
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Provider Business Mailing Address
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Address Line | 1509 DULLES DR
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City | LAFAYETTE
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State | LA
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Zip | 70506-3718
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Country | US
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Telephone | 379-919-2763
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Fax | 337-947-3084
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 29661
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License Number State | TN
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