Male or Other

Esam Ibrahim

Non-emergency Medical Transport (VAN) in Jackson, TN(View on Map)

Full Name

Esam Ibrahim

NPI Number

1316322159

NPI Type

Individual Provider

Gender

Male

Enumeration Date

07/22/2015

Specialties

(Taxonomies)

Code

343900000X

Primary Taxonomy

Yes

Licenses

State

Tennessee

License Number

2016 84394

Contact
Information

Purpose

Mailing
Location

Address

2021 N HIGHLAND AVE # 12
2021 N.HIGHLAND AVE

City

Jackson
Jackson

State

TN
TN

Postal Code

38305-4918
38305

Country

US
US

Telephone Number

(615) 506-9028
(615) 506-9028

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/22/2015

Provider Address

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