Organization
THE AKESO GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHNATHAN MILTON ISOM MD (MANAGING PARTNER)
(901) 797-9711
Entity
Organization
Contact information
Practice address
5744 NANJACK CIR, MEMPHIS, TN 38115-2061
(901) 797-9711
(901) 797-9771
Mailing address
5744 NANJACK CIR, MEMPHIS, TN 38115-2061
(901) 797-9711
(901) 797-9771
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
82822
TN
207L00000X
Anesthesiology Physician
Primary
20634
TN
367500000X
Certified Registered Nurse Anesthetist
R864279
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3706284
APPLICATIONS PROCESSING
TN
Enumeration date
08/13/2010
Last updated
10/08/2010
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