| Wolfchase Family Medical Care, Pllc | |
|
8485 Us Highway 64 Ste 101 Memphis TN 38133-4102 | |
| (901) 377-3001 | |
| (901) 377-3130 |
| Full Name | Wolfchase Family Medical Care, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8485 Us Highway 64 Ste 101, Memphis, Tennessee |
| Authorized Official Name and Position | John R Wickman (OWNER) |
| Authorized Official Contact | 9013773001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wolfchase Family Medical Care, Pllc 8485 Us Highway 64 Ste 101 Memphis TN 38133-4102 Ph: (901) 377-3001 | Wolfchase Family Medical Care, Pllc 8485 Us Highway 64 Ste 101 Memphis TN 38133-4102 Ph: (901) 377-3001 |
| NPI Number | 1972804110 |
|---|---|
| Provider Enumeration Date | 11/04/2010 |
| Last Update Date | 11/04/2010 |
| Medicare PECOS PAC ID | 7618145780 |
|---|---|
| Medicare Enrollment ID | O20110714000737 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972804110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 22064 (Tennessee) | Primary |
| 261QP2300X | Clinic/center - Primary Care | 12858 (Tennessee) | Secondary |
| Provider Name | John R Wickman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871513739 PECOS PAC ID: 8022160662 Enrollment ID: I20090713000653 |
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