Organization
BAPTIST MINOR MEDICAL CENTERS INC
Active
Parent organization
BAPTIST MEMORIAL HEALTH CARE CORP.
Other names
Baptist Minor Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAPTIST MEMORIAL HEALTH CARE CORP.
Authorized official
GREGORY M DUCKETT (SR VP/ CLO)
(901) 227-5233
Entity
Organization
Contact information
Practice address
3295 POPLAR AVE STE 105, MEMPHIS, TN 38111-4690
(901) 327-8188
(901) 327-8284
Mailing address
350 N HUMPHREYS BLVD, MEMPHIS, TN 38120-2177
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015693
—
MS
01
—
3031283
BLUE CROSS BLUE SHIELD TN
TN
05
—
3704220
—
TN
Enumeration date
05/26/2006
Last updated
09/30/2020
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