Bergeron, Jaclyn Beaghan

Bergeron, Jaclyn Beaghan is an individual health care provider with primary practice located at 1169 Jefferson Ave , Memphis TN 38104-7217. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Bergeron, Jaclyn Beaghan can be contacted via phone (901) 425-1880.

Contact Information

Primary practice address
1169 Jefferson Ave Memphis TN 38104-7217
Fax: (901) 725-5766
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 50407 Tennessee
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 50407 Tennessee

Profile Details

NPI number 1639313208
LBN Legal business name Bergeron, Jaclyn Beaghan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2009
Last updated Apr 27th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1639313208 NPPES
Tennessee MEDICAID Q013161
Tennessee Other 6055871
Tennessee MEDICAID 04058365
Tennessee MEDICAID 199952001

Popular Providers