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Organization

NORTHWEST TENNESSEE EMERGENCY PHYSICIANS, LLP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DERIK K KING MD (LLP MANAGING PARTNER)
(866) 916-5259
Entity
Organization

Contact information

Practice address
214 LAKEVIEW DRIVE, SOMERVILLE, TN 38068-9737
(901) 516-4000
(901) 466-1811
Mailing address
PO BOX 602162, CHARLOTTE, NC 28260-2162
(866) 916-5259
(231) 922-4030

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4095625
BLUE SHIELD
TN
Enumeration date
12/22/2008
Last updated
02/26/2009
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