DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: TENNESSEE PHS PC

MEDICARE: TENNESSEE PHS PC
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
1207Q00000XFamily Medicine Physician

Other Identifiers

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

General Provider Information

NPI Number : 1184854473
Entity Type Code : Organization
Provider Name (Legal Business Name) : TENNESSEE PHS PC
Provider Business Mailing Address
First Line : 1509 DULLES DRIVE
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506
Country : US
Telephone Number : 337-991-9276
Fax Number : 337-991-9288
Provider Business Practice Location Address
First Line : 9155 CRESTWYN HILLS DR
Second Line :
City : MEMPHIS
State : TN
Zip : 38125-8501
Country : US
Telephone Number : 901-261-4858
Fax Number : 901-261-4867
Authorized Official
Title or Position : CFO
Name : NICOLE HOWARD
Credential :
Telephone Number : 337-991-9276
Provider Enumeration Date : 07/21/2009
Last Update Date : 07/02/2014

Similar Medicare Providers

1003892951 — MS. CAROL W SIMMONS RN,FNP,APN
Practice Location Address:
9155 CRESTWYN HILLS DR
MEMPHIS, TN
38125-8501
Practice Phone: 901-261-4848
Practice Fax:
1770532582 — EMILY R LAIRD FNP
Practice Location Address:
9155 CRESTWYN HILLS DR
MEMPHIS, TN
38125-8501
Practice Phone: 901-261-4848
Practice Fax: 901-261-4867
1700982204 — MRS. REBECCA H ADKINS FNP
Practice Location Address:
9155 CRESTWYN HILLS DR
MEMPHIS, TN
38125-8501
Practice Phone: 877-260-4747
Practice Fax: 901-261-4867
1386966943 — OHIO PHS LLC
Practice Location Address:
9155 CRESTWYN HILLS DR
MEMPHIS, TN
38125-8501
Practice Phone: 901-261-4843
Practice Fax: 901-261-4849
1902128564 — OKLAHOMA PHS LLC
Practice Location Address:
9155 CRESTWYN HILLS DR
MEMPHIS, TN
38125-8501
Practice Phone: 901-261-4843
Practice Fax: 901-261-4849
1871802082 — NEW MEXICO PHS LLC
Practice Location Address:
9155 CRESTWYN HILLS DR
MEMPHIS, TN
38125-8501
Practice Phone: 901-261-4848
Practice Fax: 901-261-4849

Directions to “TENNESSEE PHS PC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.