Organization Name: | BAPTIST MINOR MEDICAL CENTERS INC |
NPI Number: | 1881640118 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NANCY AVERWATER (CEO) |
Mailing Address: | 3295 Poplar Ave Suite # 105 Memphis |
State: | TN US |
Postal Code: | 381114690 |
Phone Number: | 9013278713 |
Fax Number: | 9013278284 |
NPI Enumeration Date: | 05/26/2006 |
NPI Last Update Date: | 03/02/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |