1831184886 NPI number — JOHN J LOCHEMES MD

Table of content: JOHN J LOCHEMES MD (NPI 1831184886)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831184886 NPI number — JOHN J LOCHEMES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOCHEMES
Provider First Name:
JOHN
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1831184886
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
795 RIDGE LAKE BLVD
Provider Second Line Business Mailing Address:
#103
Provider Business Mailing Address City Name:
MEMPHIS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38120-9475
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-255-6532
Provider Business Mailing Address Fax Number:
901-474-7311

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
795 RIDGE LAKE BLVD
Provider Second Line Business Practice Location Address:
#103
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38120-9475
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-255-6532
Provider Business Practice Location Address Fax Number:
901-474-7311
Provider Enumeration Date:
09/15/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  MD0000028565 , 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: 1420031 . This is a "UNITED HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1514484 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00760194 . This is a "RR MEDICARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 5627964 . This is a "BCBS OF TN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 0364880 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 139240001 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




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