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GRACELAND INTERNAL MEDICINE NPI 1851317333


NPI Information

NPI: 1851317333
Provider Name: GRACELAND INTERNAL MEDICINE
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
1264 WESLEY DR
SUITE 405
MEMPHIS, TN
ZIP 38116
Phone: (901) 396-3061
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GRACELAND INTERNAL MEDICINE is an internal medicine in Memphis, TN. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. GRACELAND INTERNAL MEDICINE NPI is 1851317333. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1264 WESLEY DR
SUITE 405
MEMPHIS, TN
ZIP 38116-400
Phone: (901) 396-3061
Fax: (901) 396-7841

The provider's authorized official is Theresa F Edmiston .
The authorized official title is Administrator and has the following contact phone number (901) 340-6777.

The enumeration date for this NPI number is 7/15/2006 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineMD010326TENNESSEEYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13372151MEDICAIDTENNESSEE

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

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