Organization
EXPEDITION TRAILS EMERGENCY PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TENNA K BEHM (VP OF ENROLLMENT)
(469) 401-2386
Entity
Organization
Contact information
Practice address
4601 MEDICAL PLAZA WAY, CLARKSVILLE, IN 47129-9204
(215) 442-5029
Mailing address
PO BOX 37922, PHILADELPHIA, PA 19101-0519
(469) 401-2386
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
09/09/2013
Last updated
02/09/2018
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