Organization
SOMERVILLE EMERGENCY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT J BUNKER (CHAIRMAN/PRESIDENT/CEO)
(904) 805-1300
Entity
Organization
Contact information
Practice address
214 LAKEVIEW RD, SOMERVILLE, TN 38068-9737
(901) 465-3594
(904) 805-1302
Mailing address
PO BOX 532893, ATLANTA, GA 30353-2893
(904) 805-1300
(904) 805-1302
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3727937
—
TN
Enumeration date
05/03/2006
Last updated
07/23/2008
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