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Organization
SOUTHEASTERN EMERGENCY SERVICES OF MEMPHIS, P.C.
Active
Organization
SOUTHEASTERN EMERGENCY SERVICES OF MEMPHIS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDAL L DABBS M.D. (PRESIDENT)
(865) 693-1000
Entity
Organization
Contact information
Practice address
910 BLACKFORD ST, CHATTANOOGA, TN 37403-1405
(865) 693-1000
Mailing address
P O BOX 634811, CINCINNATI, OH 45263-4811
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200542050A
—
KS
05
—
3724132
—
TN
05
—
504604307
—
MO
05
—
529929220
—
AL
05
—
625568152A
—
GA
05
—
78904216
—
KY
Enumeration date
07/07/2006
Last updated
10/14/2020
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