Organization
JESSE M WESBERRY MD PSC
Active
Other names
Wesberry Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY LEE WESBERRY (VICE PRESIDENT/OFFICE MANAGER)
(901) 362-3100
Entity
Organization
Contact information
Practice address
2900 S PERKINS RD, MEMPHIS, TN 38118-3237
(901) 362-3100
(901) 362-3372
Mailing address
2900 S PERKINS RD, MEMPHIS, TN 38118-3237
(901) 362-3100
(901) 362-3372
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
44-1011
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005869351
AETNA PROVIDER NUMBER
TN
01
—
44-1011
STATE ASTC LICENSE
TN
01
—
490000574
RAILROAD MEDICARE
TN
01
—
81353
BCBS PROVIDER NUMBER
TN
Enumeration date
03/08/2007
Last updated
06/18/2008
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