| NPI | 1598018806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA FULLER Billing And Credentialing Manager 901-922-5951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease |
| 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism | |
| 2080N0001X Pediatrics Neonatal-Perinatal Medicine | |
| 363AM0700X Physician Assistant Medical | |
| 363LF0000X Nurse Practitioner Family | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| 152W00000X Optometrist | |
| 207R00000X Internal Medicine | |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2020-04-06 |