Provider Demographics
NPI:1689737272
Name:O'CAIN, DEBBIE TAPP (MD)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:TAPP
Last Name:O'CAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1000 DEPT 978
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-367-9001
Mailing Address - Fax:901-565-8787
Practice Address - Street 1:3725 CHAMPION HILLS DR
Practice Address - Street 2:SUITE 2000
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-2597
Practice Address - Country:US
Practice Address - Phone:901-367-9001
Practice Address - Fax:901-565-8787
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20159207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3084855Medicaid
TN4307913OtherBCBS
AR98143OtherBCBS
TNP00378650OtherRAILROAD MEDICARE
TN20159OtherLICENSE
E59113Medicare UPIN
TN3084855Medicare PIN