Organization
SOMERVILLE EMERGENCY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EUGENE DAUCHERT (AUTHORIZED OFFICIAL)
(919) 768-4392
Entity
Organization
Contact information
Practice address
214 LAKEVIEW RD, SOMERVILLE, TN 38068-9737
(901) 465-3594
Mailing address
6400 ATLANTIC BLVD, JACKSONVILLE, FL 32211-8768
(904) 805-1300
(904) 805-1456
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3727937
—
TN
01
—
56231441
TRICARE GROUP NUMBER
TN
Enumeration date
05/17/2006
Last updated
08/22/2020
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