Doctor Name: | DR. JACOB WADE ORMSBY |
NPI Number: | 1013274729 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D., M.B.A. |
License Number: | |
Business Practice Address: | University Of Tennessee 910 Madison Avenue Suite 1031 Memphis, TN - 381630001 |
Business Phone Number: | 9014485364 |
Business Fax Number: | |
Mailing Address: | 1265 Union Avenue, Methodist Healthcare Department Of Radiology MEMPHIS |
State: | TN |
Postal Code: | 38104 |
Phone Number: | 9015167358 |
Fax Number: | 9015167490 |
NPI Enumeration Date: | 04/19/2012 |
NPI Last Update Date: | 04/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |