Provider Demographics
NPI:1922520873
Name:TELEMEDICO PHYSICIANS PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:TELEMEDICO PHYSICIANS PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:OKNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:866-227-3606
Mailing Address - Street 1:5490 SHADY GROVE TER
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2414
Mailing Address - Country:US
Mailing Address - Phone:866-227-3606
Mailing Address - Fax:773-439-2444
Practice Address - Street 1:5490 SHADY GROVE TER
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2414
Practice Address - Country:US
Practice Address - Phone:866-227-3606
Practice Address - Fax:773-439-2444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036079417207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty