| North Memphis Medical Clinic | |
|
3950 New Covington Pike Suite # 130 Memphis TN 38128-2591 | |
| (347) 423-2301 | |
| Not Available |
| Full Name | North Memphis Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 3950 New Covington Pike, Memphis, Tennessee |
| Authorized Official Name and Position | Emmanuel Iloh (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3474232301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Memphis Medical Clinic 3950 New Covington Pike Suite # 130 Memphis TN 38128-2591 Ph: (347) 423-2301 | North Memphis Medical Clinic 3950 New Covington Pike Suite # 130 Memphis TN 38128-2591 Ph: (347) 423-2301 |
| NPI Number | 1629370648 |
|---|---|
| Provider Enumeration Date | 11/23/2010 |
| Last Update Date | 11/23/2010 |
| Medicare PECOS PAC ID | 1759578057 |
|---|---|
| Medicare Enrollment ID | O20101213000948 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629370648 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Emmanuel C Iloh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801826961 PECOS PAC ID: 1850369158 Enrollment ID: I20040923001134 |
| Provider Name | Leandra Peacock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619477981 PECOS PAC ID: 0547524498 Enrollment ID: I20180501002605 |
| Provider Name | Jo'niece P. Redmond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386290369 PECOS PAC ID: 7214269562 Enrollment ID: I20191106000393 |
| Provider Name | Latoya Shantae Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235744525 PECOS PAC ID: 7214346006 Enrollment ID: I20210507000182 |
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