Individual
JACINTO A HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6490 MT MORIAH RD EXT, MEMPHIS, TN 38115-3729
(901) 565-0244
(901) 565-0616
Mailing address
6490 MOUNT MORIAH ROAD EXT, STE 200, MEMPHIS, TN 38115-3841
(901) 565-0244
(901) 565-9605
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
12320
TN
207RN0300X
Nephrology Physician
14556
MS
207RN0300X
Nephrology Physician
R3093
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0120587
—
MS
05
—
053526
—
TN
05
—
102001001
—
AR
05
—
116432
—
TN
01
—
1680070005
CIGNA
—
05
—
208992313
—
MO
05
—
3105
—
TN
05
—
3188369
—
TN
01
—
4023944
BLUE CROSS BLUE SHIELD
TN
01
—
56207
BLUE CROSS BLUE SHIELD
AR
Enumeration date
03/14/2006
Last updated
12/24/2019
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