Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD0000026445 | TN |
N | 111NI0900X | Internist | MD0000026445 | TN |
N | 207RI0200X | Infectious Disease | MD0000026445 | TN |
NPI | 1003858168 |
---|---|
Provider Name | Manoj K Jain |
First Address | Memphis, TN 38120-2145 |
Second Address | Memphis, TN 38120-2145 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00116301 | (05) | MS |
3090453 | (05) | TN |
G03553 | (02) | TN |