| Organization Name: | CAREMORE MEDICAL GROUP OF TENNESSEE PC |
| NPI Number: | 1265834048 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM G RUNYON (SHAREHOLDER/PRESIDENT/DIRECTOR) |
| Mailing Address: | 1169 Jefferson Memphis |
| State: | TN US |
| Postal Code: | 38104 |
| Phone Number: | 5626222905 |
| Fax Number: | |
| NPI Enumeration Date: | 09/23/2014 |
| NPI Last Update Date: | 09/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD0000044393 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |