| NPI | 1942415245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL W MITCHELL Billing Manager 901-432-1591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN MD28107) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN MD17825) |
| 208000000X Pediatrics (Licence: TN MD18312) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |