| Doctor Name: | MR. PRESTON PARKER EMBREY |
| NPI Number: | 1104059765 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | 1768 |
| Business Practice Address: | 1718 Parr Ave Ste C Dyersburg, TN - 380242071 |
| Business Phone Number: | 7312864445 |
| Business Fax Number: | 7312864452 |
| Mailing Address: | 1718 Parr Ave Ste C, DYERSBURG |
| State: | TN |
| Postal Code: | 380242071 |
| Phone Number: | 7312864445 |
| Fax Number: | 7312864452 |
| NPI Enumeration Date: | 08/31/2009 |
| NPI Last Update Date: | 01/22/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 1768 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |