Provider Demographics
NPI:1831403484
Name:FRANKIE J EUBANKS
Entity type:Organization
Organization Name:FRANKIE J EUBANKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACINTA
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-552-3338
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:TN
Mailing Address - Zip Code:38320-0129
Mailing Address - Country:US
Mailing Address - Phone:731-697-0165
Mailing Address - Fax:931-647-4358
Practice Address - Street 1:500 STIRLING RD
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:TN
Practice Address - Zip Code:38320-7722
Practice Address - Country:US
Practice Address - Phone:731-697-0165
Practice Address - Fax:931-647-4358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000038334367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0108023OtherBCBS
TN3600805Medicaid
TN1699814418OtherIND NPI
TN3600805Medicaid