E E Hines Iii Md, Pc | |
6263 Poplar Ave Ste 1052 Memphis TN 38119-4701 | |
(901) 761-6157 | |
(901) 761-4145 |
Full Name | E E Hines Iii Md, Pc |
---|---|
Speciality | Family Medicine |
Location | 6263 Poplar Ave, Memphis, Tennessee |
Authorized Official Name and Position | Elbert E. Hines (PRESIDENT) |
Authorized Official Contact | 9017616157 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
E E Hines Iii Md, Pc 3665 Ellen Davies Cv Bartlett TN 38133-0940 Ph: (901) 849-7065 | E E Hines Iii Md, Pc 6263 Poplar Ave Ste 1052 Memphis TN 38119-4701 Ph: (901) 761-6157 |
NPI Number | 1083758122 |
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Provider Enumeration Date | 02/19/2007 |
Last Update Date | 02/11/2015 |
Medicare PECOS PAC ID | 8224175245 |
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Medicare Enrollment ID | O20091023000546 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083758122 | NPI | - | NPPES |
002008944 | Other | BLUE CROSS BLUE SHIELD | |
CL0583 | Other | TN | RAILROAD MEDICARE |
4409209005 | Other | CIGNA | |
3389063 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
Provider Name | Elbert E Hines |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1801896881 PECOS PAC ID: 3274426093 Enrollment ID: I20040615000325 |
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