Organization
JACKSON ENDOCRINE AND DIABETES CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERNEST K ANTWI M.D. (OWNER)
(731) 421-8908
Entity
Organization
Contact information
Practice address
110 E FOREST AVE, JACKSON, TN 38301-4124
(731) 421-8908
(731) 421-8469
Mailing address
PO BOX 1798, DEPT 07-028, MEMPHIS, TN 38101-1798
(731) 421-8908
(731) 421-8469
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3712830
—
TN
Enumeration date
12/15/2006
Last updated
05/13/2013
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