Organization
MEDSOUTH HEALTHCARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID W ALRED (ADMINISTRATOR)
(731) 287-4512
Entity
Organization
Contact information
Practice address
1700 WOODLAWN AVE, DYERSBURG, TN 38024-2028
(731) 287-4500
(731) 287-4804
Mailing address
1700 WOODLAWN AVE, DYERSBURG, TN 38024-2028
(731) 287-4500
(731) 287-4804
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3705380
—
TN
05
—
3705383
—
TN
05
—
3705385
—
TN
05
—
3705386
—
TN
05
—
3705388
—
TN
05
—
3705389
—
TN
Enumeration date
09/14/2005
Last updated
09/11/2025
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