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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

NPI Number 1437105277
LBN Legal business name SOUTHEASTERN EMERGENCY PHYSICIANS OF MEMPHIS LLC
Authorized official MICHAEL CORVINI - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/25/2006
Last updated 09/29/2020 - About 6 years ago
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
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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