| Jackson Endocrine And Diabetes Center Pc | |
|
110 E Forest Ave Jackson TN 38301-4124 | |
| (731) 421-8908 | |
| (731) 421-8469 |
| Full Name | Jackson Endocrine And Diabetes Center Pc |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 110 E Forest Ave, Jackson, Tennessee |
| Authorized Official Name and Position | Ernest K Antwi (OWNER) |
| Authorized Official Contact | 7314218908 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Endocrine And Diabetes Center Pc Po Box 1798 Dept 07-028 Memphis TN 38101-1798 Ph: (731) 421-8908 | Jackson Endocrine And Diabetes Center Pc 110 E Forest Ave Jackson TN 38301-4124 Ph: (731) 421-8908 |
| NPI Number | 1538221551 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 05/13/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538221551 | NPI | - | NPPES |
| 3712830 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
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