Provider Demographics
NPI:1871120766
Name:CONCIERGE EMERGENCY MEDICAL GROUP, PLLC
Entity type:Organization
Organization Name:CONCIERGE EMERGENCY MEDICAL GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-725-3898
Mailing Address - Street 1:6075 POPLAR AVENUE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-0114
Mailing Address - Country:US
Mailing Address - Phone:901-795-3800
Mailing Address - Fax:901-795-6060
Practice Address - Street 1:4200 TWELVE OAKS PLACE
Practice Address - Street 2:SUITE 401
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-6899
Practice Address - Country:US
Practice Address - Phone:713-980-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-23
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty