MEDICARE: ALLAN M MENACHEM 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
1	207RG0100X	Gastroenterology Physician	39256	TN

Other Identifiers

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

General Provider Information

NPI Number	:	1700873056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLAN M MENACHEM MD

Provider Business Mailing Address
First Line	:	PO BOX 11567
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38308-0126
Country	:	US
Telephone Number	:	731-661-0086
Fax Number	:	731-661-9702

Provider Business Practice Location Address
First Line	:	9 PHYSICIANS DR
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-2071
Country	:	US
Telephone Number	:	731-661-0086
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	03/07/2023

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Directions to “ ALLAN M MENACHEM MD” Practice Location

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