Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 31769 | TN |
Y | 2080P0206X | Pediatric Gastroenterologist | 31769 | TN |
NPI | 1659372613 |
---|---|
Provider Name | Dr. John K Eshun |
First Address | Memphis, TN 38103-2816 |
Second Address | Memphis, TN 38103-2816 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 24/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3496259 | (05) | TN |
G86234 | (02) | TN |