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NPI Code Detail

MEDICARE: EMILY T WOLFE MD

MEDICARE: EMILY T WOLFE 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
12086S0122XPlastic and Reconstructive Surgery Physician55896TN

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 : 1437386232
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY T WOLFE MD
Provider Business Mailing Address
First Line : PO BOX 400
Second Line :
City : JACKSON
State : TN
Zip : 38302-0400
Country : US
Telephone Number : 731-425-5752
Fax Number : 731-422-5743
Provider Business Practice Location Address
First Line : 87 MURRAY GUARD DR STE B
Second Line :
City : JACKSON
State : TN
Zip : 38305-3775
Country : US
Telephone Number : 731-422-0213
Fax Number : 731-422-0475
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2009
Last Update Date : 07/21/2022

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