| North Internal Medicine, P. C. | |
|
4901 Raleigh Commons Drive Suite 200 Memphis TN 38128 | |
| (901) 387-0193 | |
| (901) 387-0796 |
| Full Name | North Internal Medicine, P. C. |
|---|---|
| Speciality | Internal Medicine |
| Location | 4901 Raleigh Commons Drive, Memphis, Tennessee |
| Authorized Official Name and Position | Dudley Kelso (OFFICE MANAGER) |
| Authorized Official Contact | 9013870193 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Internal Medicine, P. C. Po Box 216 Memphis TN 38101-0216 Ph: (901) 387-0193 | North Internal Medicine, P. C. 4901 Raleigh Commons Drive Suite 200 Memphis TN 38128 Ph: (901) 387-0193 |
| NPI Number | 1518982008 |
|---|---|
| Provider Enumeration Date | 07/13/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1355242959 |
|---|---|
| Medicare Enrollment ID | O20040116000448 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518982008 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Douglas Lawrence Odea |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316974132 PECOS PAC ID: 3072406909 Enrollment ID: I20050225000467 |
| Provider Name | Jamie W Covington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053300335 PECOS PAC ID: 8022043843 Enrollment ID: I20050929001373 |
| Provider Name | Debora Dowda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124059365 PECOS PAC ID: 8123161924 Enrollment ID: I20100202000495 |
| Provider Name | Myles B Benjamin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831474485 PECOS PAC ID: 6103072533 Enrollment ID: I20141028002766 |
| Provider Name | Rachael O'dea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356941645 PECOS PAC ID: 9739591959 Enrollment ID: I20201211002744 |
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