Basic Information
| Provider Information | |||||||||
| NPI: | 1851725162 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EAST MEMPHIS ANESTHESIA SERVICES, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 171181 | ||||||||
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| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381871181 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2996 KATE BOND RD | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | BARTLETT | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381334030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9016822872 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2013 | ||||||||
| LastUpdateDate: | 08/23/2013 | ||||||||
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| AuthorizedOfficialLastName: | ESKIN | ||||||||
| AuthorizedOfficialFirstName: | MARC | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9016822872 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | EAST MEMPHIS ANESTHESIA SERVICES, PLLC | ||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine |
No ID Information.