MEMPHIS PEDIATRIC GASTROENTEROLOGY & HEPATOLOGY PC NPI 1750455945

NPI Information

NPI: 1750455945
Provider Name: MEMPHIS PEDIATRIC GASTROENTEROLOGY & HEPATOLOGY PC
Classification: Pediatrics - 2080P0206X
Entity Type: Organization

Specialization: Pediatric Gastroenterology

Address:
806 ESTATE PL
MEMPHIS, TN
ZIP 38120
Phone: (901) 287-4017
Get Directions

MEMPHIS PEDIATRIC GASTROENTEROLOGY & HEPATOLOGY PC is a pediatric gastroenterology pediatrics in Memphis, TN. The provider is a pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. MEMPHIS PEDIATRIC GASTROENTEROLOGY & HEPATOLOGY PC NPI is 1750455945. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

806 ESTATE PL
MEMPHIS, TN
ZIP 38120-600
Phone: (901) 287-4017
Fax: (901) 287-4013

The provider's authorized official is Robin L Reese .
The authorized official title is Office Manager and has the following contact phone number (901) 458-4282.

The enumeration date for this NPI number is 11/20/2006 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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080P0206X	Pediatrics	Pediatric Gastroenterology			Yes

Other Identifiers

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

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3387689	OTHER	TENNESSEE	AARP CLAIM UNIT
2	3387689	OTHER	TENNESSEE	HEALTHSOURCE
3	0048573	OTHER	TENNESSEE	BLUE CROSS GROUP ID
4	84107	OTHER	ARKANSAS	ARK FIRST SOURCE
5	84107	OTHER	ARKANSAS	BLUE CROSS OF ARKANSAS
6	84107	OTHER	ARKANSAS	US ABLE ADMINISTRATOR
7	09010528	MEDICAID	MISSISSIPPI
8	3387689	MEDICAID	TENNESSEE

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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