Provider Demographics
NPI:1548441546
Name:METHODIST HEALTHCARE PRIMARY CARE ASSOCIATES
Entity type:Organization
Organization Name:METHODIST HEALTHCARE PRIMARY CARE ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-516-0725
Mailing Address - Street 1:3950 NEW COVINGTON PIKE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-2591
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3950 NEW COVINGTON PIKE
Practice Address - Street 2:SUITE 130
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-2591
Practice Address - Country:US
Practice Address - Phone:901-516-0843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty