MEDICARE: FIRSTCARE MEDICAL CENTER, 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
1	207RC0000X	Cardiovascular Disease Physician

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	:	1922212067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRSTCARE MEDICAL CENTER, PC

Provider Business Mailing Address
First Line	:	PO BOX 1798 DEPT 07-031
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38101
Country	:	US
Telephone Number	:	731-512-0043
Fax Number	:	731-512-0015

Provider Business Practice Location Address
First Line	:	168 W UNIVERSITY PKWY
Second Line	:	SUITE A & B
City	:	JACKSON
State	:	TN
Zip	:	38305-1624
Country	:	US
Telephone Number	:	731-512-0043
Fax Number	:	731-512-0015

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. EMMANUEL I OBI
Credential	:	MD
Telephone Number	:	731-772-3442

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	08/22/2020

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