FIRSTCARE MEDICAL CENTER PC NPI 1922212067

NPI Information

NPI: 1922212067
Provider Name: FIRSTCARE MEDICAL CENTER, PC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

CLIA Number: 44D0996983

Address:
168 W UNIVERSITY PKWY
SUITE A & B
JACKSON, TN
ZIP 38305
Phone: (731) 512-0043
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FIRSTCARE MEDICAL CENTER, PC is a cardiovascular disease internal medicine in Jackson, TN. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. FIRSTCARE MEDICAL CENTER, PC NPI is 1922212067. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

168 W UNIVERSITY PKWY
SUITE A & B
JACKSON, TN
ZIP 38305-624
Phone: (731) 512-0043
Fax: (731) 512-0015

The provider's authorized official is Emmanuel I Obi .
The authorized official title is Medical Director and has the following contact phone number (731) 772-3442.

The CLIA number assigned to this NPI record is 44D0996983 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/9/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3377799	MEDICAID	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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