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Contact Information

SOUTHEASTERN EMERGENCY PHYSICIANS OF MEMPHIS LLC
1 MEMORIAL DR
ALTON, IL62002-6722
 Phone: 618-463-7474
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Pediatric Emergency Medicine

207PP0204X 93 Physician/Emergency Medicine
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for SOUTHEASTERN EMERGENCY PHYSICIANS OF MEMPHIS LLC · (Female)

NPI # 1437105277
Status Active
Credentials
Entity Individual
Enumeration date 05/25/2006
Last updated 09/29/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • AL Medicaid 529932817
  • AR Medicaid 158441002
  • IN Medicaid 200924580A
  • KS Medicaid 200533140A
  • KY Medicaid 65909962
  • KY Medicaid 65919342
  • MO Medicaid 507218402
  • TN Medicaid 3728394
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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