| Premier Internal Medicine And Pediatrics Pllc | |
|
714 Federal Dr Selmer TN 38375-1876 | |
| (731) 540-9083 | |
| (731) 540-9103 |
| Full Name | Premier Internal Medicine And Pediatrics Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 714 Federal Dr, Selmer, Tennessee |
| Authorized Official Name and Position | Keith Lou Anthony Perkins (OWNER) |
| Authorized Official Contact | 7315066995 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Internal Medicine And Pediatrics Pllc 714 Federal Dr Selmer TN 38375-1876 Ph: (731) 540-9083 | Premier Internal Medicine And Pediatrics Pllc 714 Federal Dr Selmer TN 38375-1876 Ph: (731) 540-9083 |
| NPI Number | 1629503859 |
|---|---|
| Provider Enumeration Date | 04/25/2017 |
| Last Update Date | 11/09/2017 |
| Medicare PECOS PAC ID | 6507139227 |
|---|---|
| Medicare Enrollment ID | O20170831001682 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629503859 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 46862 (Tennessee) | Primary |
| Provider Name | Keith L Perkins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225253883 PECOS PAC ID: 5496923500 Enrollment ID: I20110715000381 |
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