MEDICARE: ASAD AZIM 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	2086X0206X	Surgical Oncology Physician	73723	TN

General Provider Information

NPI Number	:	1831626852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASAD AZIM MD

Provider Business Mailing Address
First Line	:	257 BANCORP SOUTH PKWY
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-7582
Country	:	US
Telephone Number	:
Fax Number	:	731-664-0057

Provider Business Practice Location Address
First Line	:	569 SKYLINE DR
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38301-3911
Country	:	US
Telephone Number	:	731-664-7395
Fax Number	:

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

Provider Enumeration Date	:	05/22/2017
Last Update Date	:	03/11/2026

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