Organization
CORMORANT EMERGENCY PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSS RONAN (VICE PRESIDENT)
(469) 401-2386
Entity
Organization
Contact information
Practice address
705 E POPLAR AVE, SELMER, TN 38375-1828
(731) 645-3221
Mailing address
13737 NOEL RD, SUITE 1600, DALLAS, TX 75240-1331
(469) 401-2386
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
03/07/2014
Last updated
03/07/2014
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