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NPI Code Detail

MEDICARE: GUY V TEACH MD

MEDICARE: GUY V TEACH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1173000000XLegal Medicine047541GA
2208M00000XHospitalist Physician43045TN
3207R00000XInternal Medicine Physician43045TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3047541OTHERGASTATE LICENSE

General Provider Information

NPI Number : 1073594909
Entity Type Code : Individual
Provider Name (Legal Business Name) : GUY V TEACH MD
Provider Business Mailing Address
First Line : PO BOX 535
Second Line :
City : BRIGHTON
State : TN
Zip : 38011-0535
Country : US
Telephone Number : 770-317-3692
Fax Number :
Provider Business Practice Location Address
First Line : 6019 WALNUT GROVE RD
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-2113
Country : US
Telephone Number : 901-226-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2005
Last Update Date : 01/19/2021

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