| South Md Pc | |
|
1300 Wesley Dr Memphis TN 38116-6426 | |
| (901) 570-7438 | |
| Not Available |
| Full Name | South Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1300 Wesley Dr, Memphis, Tennessee |
| Authorized Official Name and Position | Oluwatoyin Jimmy Agbaosi (PRESIDENT) |
| Authorized Official Contact | 9015707438 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Md Pc Po Box 16384 Memphis TN 38186-0384 Ph: (901) 570-7438 | South Md Pc 1300 Wesley Dr Memphis TN 38116-6426 Ph: (901) 570-7438 |
| NPI Number | 1609129139 |
|---|---|
| Provider Enumeration Date | 10/22/2012 |
| Last Update Date | 06/03/2016 |
| Medicare PECOS PAC ID | 2668624735 |
|---|---|
| Medicare Enrollment ID | O20121218000595 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609129139 | NPI | - | NPPES |
| 1530261 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Tennessee) | Primary |
| Provider Name | Oluwatoyin Agbaosi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265675201 PECOS PAC ID: 7810031820 Enrollment ID: I20100215000230 |
| Provider Name | Tina A Agbaosi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740423417 PECOS PAC ID: 7911179247 Enrollment ID: I20111011000384 |
Christ Commuity Health Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3360 S 3rd St, Memphis, TN 38109 Phone: 901-842-3160 Fax: 901-842-2360 | |
Elite Patient Care Of Tennessee Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 Peabody Pl Ste 150, Memphis, TN 38103 Phone: 337-408-0797 | |
Jerry M Holley Md Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4100 Austin Peay Hwy, Memphis, TN 38128 Phone: 901-486-1151 Fax: 901-844-1439 | |
Spirit Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1331 Union Ave Ste 1240, Memphis, TN 38104 Phone: 901-832-6734 | |
Peabody Family Care, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1325 Eastmoreland Avenue, Suite 150, Memphis, TN 38104 Phone: 901-725-0648 Fax: 901-725-1037 | |
Eastmoreland Internal Medicine Mpllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1325 Eastmoreland Avenue, Ste 245, Memphis, TN 38104 Phone: 901-729-3700 Fax: 901-729-3750 | |
Muh Weight Management Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1325 Eastmoreland Ave Ste 550, Memphis, TN 38104 Phone: 901-448-6635 Fax: 901-448-5721 |