MID SOUTH WELLNESS CENTER INC NPI 1932258787

NPI Information

  • NPI: 1932258787
  • Provider Name: MID SOUTH WELLNESS CENTER, INC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 44D2301882
  • Address: 7662 HIGHWAY 51NORTH
    SUITE 2
    MILLINGTON, TN
    ZIP 38053
  • Phone: (901) 873-2555

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NPI Details

MID SOUTH WELLNESS CENTER, INC is a family medicine in Millington, TN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MID SOUTH WELLNESS CENTER, INC NPI is 1932258787. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7662 HIGHWAY 51NORTH
SUITE 2
MILLINGTON, TN
ZIP 38053
Phone: (901) 873-2555
Fax: (901) 873-2561

The provider's authorized official is Jerry Ray Floyd .
The authorized official title is Owner and has the following contact phone number (901) 873-2555.

The CLIA number assigned to this NPI record is 44D2301882 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/10/2007 and was last updated on 12/6/2007.

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
1207Q00000XFamily MedicineMD0000028821TENNESSEEYes

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
13378385MEDICARE ID-TYPE UNSPECIFIEDTENNESSEEMEDICARE NUMBER
23378384MEDICAIDTENNESSEE
3G53357MEDICARE UPINTENNESSEE

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: 11/21/2025

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