Organization
PEABODY FAMILY CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAM ALEXANDER (ADMINISTRATOR)
(901) 756-5565
Entity
Organization
Contact information
Practice address
1325 EASTMORELAND AVENUE, SUITE 150, MEMPHIS, TN 38104-3519
(901) 725-0648
(901) 725-1037
Mailing address
PO BOX 1000 DEPT 297, MEMPHIS, TN 38148-0001
(901) 725-0648
(901) 725-1037
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015606
—
MS
05
—
3723978
—
TN
01
—
8P078
BCBS AR-GROUP#
AR
01
—
CG9962
RAILROAD MEDICARE
—
Enumeration date
06/05/2006
Last updated
10/12/2011
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