CONRAD PEARSON CLINIC PC NPI 1992758882

NPI Information

NPI: 1992758882
Provider Name: CONRAD PEARSON CLINIC PC

Former Legal Business Name: THE CONRAD PEARSON CLINIC

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
1325 WOLF PARK DR STE 102
GERMANTOWN, TN
ZIP 38138
Phone: (901) 252-3400
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CONRAD PEARSON CLINIC PC is a multi-specialty clinic center in Germantown, TN. CONRAD PEARSON CLINIC PC NPI is 1992758882. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is The Conrad Pearson Clinic.

The provider's business location address is:

1325 WOLF PARK DR STE 102
GERMANTOWN, TN
ZIP 38138-759
Phone: (901) 252-3400
Fax: (901) 682-0047

The provider's authorized official is Russell A Degeorge .
The authorized official title is Ceo and has the following contact phone number (901) 252-3400.

The enumeration date for this NPI number is 5/19/2006 and was last updated on 4/15/2024.

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	208800000X	Urology		N/A FOR THE GROUP	TENNESSEE	No
2	261QM1300X	Clinic/Center	Multi-Specialty			Yes

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: 5/5/2024

NPI Synchronization or Removal

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