Provider Demographics
NPI:1962715524
Name:RONALD L. TERHUNE, M.D., P.C.
Entity type:Organization
Organization Name:RONALD L. TERHUNE, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:LYTLE
Authorized Official - Last Name:TERHUNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:901-685-8202
Mailing Address - Street 1:740 BARTLETT RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38122-3004
Mailing Address - Country:US
Mailing Address - Phone:901-685-8202
Mailing Address - Fax:901-682-3525
Practice Address - Street 1:740 BARTLETT RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38122-3004
Practice Address - Country:US
Practice Address - Phone:901-685-8202
Practice Address - Fax:901-682-3525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5464207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB00943Medicare UPIN