Organization
SOUTHEASTERN EMERGENCY PHYSICIANS OF MEMPHIS LLC
Active
Organization
SOUTHEASTERN EMERGENCY PHYSICIANS OF MEMPHIS LLC
Active
Other names
S E Emergency Phys Memphis
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL D CORVINI MD (PRESIDENT)
(865) 293-5205
Entity
Organization
Contact information
Practice address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 463-7474
Mailing address
PO BOX 633819, CINCINNATI, OH 45263-3819
(888) 203-1274
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
TN
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
—
TN
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158441002
—
AR
05
—
200533140A
—
KS
05
—
200924580A
—
IN
05
—
3728394
—
TN
05
—
507218402
—
MO
05
—
529932817
—
AL
05
—
65909962
—
KY
05
—
65919342
—
KY
Enumeration date
05/25/2006
Last updated
09/29/2020
Update your record
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