Individual
DR. KASEM GHANNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
620 SKYLINE DR, JACKSON, TN 38301-3923
(731) 541-0000
Mailing address
620 SKYLINE DR, JACKSON, TN 38301-3923
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
6303
TN
207Q00000X
Family Medicine Physician
125081037
IL
Other
Enumeration date
07/01/2022
Last updated
07/24/2025
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