Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Executive Outcomes PC

Organization Internal Medicine Physician · NPI 1821352808

Executive Outcomes PC is an Internal Medicine Physician in Jackson, Tennessee. Registered with an NPI since 2012.

In the registry since
2012
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

379 Hospital Blvd
Jackson, TN 38305-2080
Phone: (731) 661-6330
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1821352808
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Monico Banez — Owner · (731) 234-5717
NPI enumeratedJune 25, 2012
Last updated in NPPESAugust 14, 2025
Certification dateAugust 14, 2025
Mailing addressPo Box 11355, Jackson, TN 38308-0122

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