Provider Demographics
NPI:1427066695
Name:PEDIATRICS EAST INC
Entity type:Organization
Organization Name:PEDIATRICS EAST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMIN
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:EMBREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-757-3522
Mailing Address - Street 1:8110 WALNUT RUN RD
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018
Mailing Address - Country:US
Mailing Address - Phone:901-757-3550
Mailing Address - Fax:901-757-3549
Practice Address - Street 1:8110 WALNUT RUN RD
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018
Practice Address - Country:US
Practice Address - Phone:901-757-3550
Practice Address - Fax:901-757-3549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty