| NPI | 1215569207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVA M THOMAS Billing/Credentialing 901-219-9903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2025-07-25 |