| Amy Funderburk, Md Pc | |
|
1282 Union Ave Memphis TN 38104-3414 | |
| (901) 761-6157 | |
| (901) 761-6145 |
| Full Name | Amy Funderburk, Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1282 Union Ave, Memphis, Tennessee |
| Authorized Official Name and Position | Amy E Funderburk (OWNER) |
| Authorized Official Contact | 9017673157 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy Funderburk, Md Pc Po Box 770390 Memphis TN 38177-0390 Ph: () - | Amy Funderburk, Md Pc 1282 Union Ave Memphis TN 38104-3414 Ph: (901) 761-6157 |
| NPI Number | 1376709451 |
|---|---|
| Provider Enumeration Date | 07/29/2008 |
| Last Update Date | 11/07/2023 |
| Medicare PECOS PAC ID | 3779934187 |
|---|---|
| Medicare Enrollment ID | O20240110002997 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376709451 | NPI | - | NPPES |
| 3843367 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD31772 (Tennessee) | Primary |
| Provider Name | Amy Elise Funderburk Mock |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114919370 PECOS PAC ID: 7618147448 Enrollment ID: I20110902000167 |
| Provider Name | Barbara Helena Dennis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831584622 PECOS PAC ID: 5395066120 Enrollment ID: I20150605000539 |
| Provider Name | Amber Elizabeth Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053791616 PECOS PAC ID: 8527364421 Enrollment ID: I20160302001235 |
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