Provider Demographics
NPI:1144357799
Name:DR. MARK ARMSTRONG MD PC
Entity type:Organization
Organization Name:DR. MARK ARMSTRONG MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-382-1200
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:DEPT 590
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-382-1200
Mailing Address - Fax:901-382-8070
Practice Address - Street 1:1722 E REELFOOT AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-6050
Practice Address - Country:US
Practice Address - Phone:901-382-1200
Practice Address - Fax:901-382-8070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000038418367500000X
TNMD0000027706207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3630468Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
3374351Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER