SELENE CLARISSA KOO MD PHD NPI 1205122967

NPI Information

NPI: 1205122967
Provider Name: SELENE CLARISSA KOO, MD, PHD
Classification: Pathology - 207ZP0213X
Entity Type: Individual

Specialization: Pediatric Pathology

PECOS Registration: Yes

Address:
262 DANNY THOMAS PL
MEMPHIS, TN
ZIP 38105
Phone: (888) 226-4343
Get Directions

Selene Clarissa Koo, MD, PHD is a pediatric pathology pathology in Memphis, TN. The provider is a pediatric pathologist is expert in the laboratory diagnosis of diseases that occur during fetal growth, infancy and child development. The practice requires a strong foundation in general pathology and substantial understanding of normal growth and development, along with extensive knowledge of pediatric medicine. Selene Clarissa Koo, MD, PHD NPI is 1205122967. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

262 DANNY THOMAS PL
MEMPHIS, TN
ZIP 38105-678
Phone: (888) 226-4343

The NPI 1205122967 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/21/2011 and was last updated on 5/14/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207ZP0213X	Pathology	Pediatric Pathology	62776	TENNESSEE	Yes
2	207ZP0102X	Pathology	Anatomic Pathology & Clinical Pathology	125059369	ILLINOIS	No
3	207ZP0102X	Pathology	Anatomic Pathology & Clinical Pathology	35.132164	OHIO	No
4	207ZP0102X	Pathology	Anatomic Pathology & Clinical Pathology	62776	TENNESSEE	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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