Provider Demographics
NPI:1124077748
Name:BEECHLAKE EMERGENCY PHYSICIANS
Entity type:Organization
Organization Name:BEECHLAKE EMERGENCY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP, EMCARE PHYSICIAN PROVIDERS INC
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-444-7009
Mailing Address - Street 1:815 S PALAFOX ST
Mailing Address - Street 2:STE 300
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-5937
Mailing Address - Country:US
Mailing Address - Phone:800-444-7009
Mailing Address - Fax:800-305-3233
Practice Address - Street 1:200 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-2014
Practice Address - Country:US
Practice Address - Phone:731-968-3646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3730641Medicaid
TN=========OtherCHAMPUS/TRICARE
TNDD5004Medicare PIN
TN3730641Medicare PIN