MEMPHIS & SHELBY COUNTY PEDIATRIC GROUP NPI 1487797536

NPI Information

MEMPHIS & SHELBY COUNTY PEDIATRIC GROUP is an adolescent medicine pediatrics in Memphis, TN. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. MEMPHIS & SHELBY COUNTY PEDIATRIC GROUP NPI is 1487797536. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6479 WINCHESTER RD
SUITE 118
MEMPHIS, TN
ZIP 38115-240
Phone: (901) 866-2133
Fax: (901) 866-2136

The provider's authorized official is Katherine Carter .
The authorized official title is Billing Supervisor and has the following contact phone number (901) 396-8366.

The CLIA number assigned to this NPI record is 44D0956888 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/15/2007 and was last updated on 8/22/2020.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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