Brookhaven Medical Clinic Pc

NPI 1366510679 - Internal Medicine - 207R00000X

NPI Details
NPI 1366510679
Enumeration Date 12/04/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name SANDY BASTIN SANDY
Position OFFICE MANAGER
Phone (901) 767-3030
Fax (901) 767-3929
Practice Location
711 BROOKHAVE CIRCLE WEST
MEMPHIS TN, 38117, US
Phone (901) 767-3030
Fax (901) 767-3929
Business Location
711 BROOKHAVE CIRCLE WEST
MEMPHIS TN, 38117, US
Phone (901) 767-3030
Fax (901) 767-3929
Toxanomy
Taxonomy Code 207R00000X
License State Tennessee
License Number MD0000006842
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According to our database, Brookhaven Medical Clinic Pc NPI is 1366510679, taxonomy code is 207R00000X and license number is MD0000006842, license state is located at Tennessee. Brookhaven Medical Clinic Pc physically located at 711 Brookhave Circle West, Memphis TN, 38117. NPI Number 1033115704 has the healthcare provider type.

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1366510679 NPI number is provided on an as is basis without warranty of any kind. 1366510679 is maintained by the National Plan & Provider Enumeration System. The contents of Brookhaven Medical Clinic Pc are for informational purposes only.