1629243175 NPI number — MONICA A. PASLEY, MD

Table of content: (NPI 1629243175)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629243175 NPI number — MONICA A. PASLEY, MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MONICA A. PASLEY, MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FIRST CHOICE CENTER FOR WOMEN
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629243175
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 383167
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GERMANTOWN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38183-3167
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-685-6815
Provider Business Mailing Address Fax Number:
901-685-6809

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6027 WALNUT GROVE RD
Provider Second Line Business Practice Location Address:
SUITE 216
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38120-2145
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-685-6815
Provider Business Practice Location Address Fax Number:
901-685-6809
Provider Enumeration Date:
04/25/2008

Additional Information

Authorized Official

Authorized Official Last Name:
PASLEY
Authorized Official First Name:
MONICA
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
901-685-6815

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X , with the licence number:  38688 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 44D1065483 . This is a "CLIA" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com