Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 39457 | TN |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | MD0000039457 | TN |
NPI | 1154369932 |
---|---|
Provider Name | Dr. Jeffrey E Kerlan |
First Address | Germantown, TN 38138-1727 |
Second Address | Memphis, TN 38120-2131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 27/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I29156 | (02) | TN |