| NPI | 1093016651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABATHA PERRY Manager, Provider Enrollment 901-478-0954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 207V00000X Obstetrics & Gynecology | |
| 363A00000X Physician Assistant | |
| 207RR0500X Internal Medicine, Rheumatology | |
| Enumeration Date | 2010-11-12 |
| Last Update Date | 2025-09-22 |