Memphis Dermatology Clinic PA
Dermatology in Memphis, TN. Organization (NPI-2).
NPI number1366416653
StatusActive
Last updated in NPPESApr 15, 2024
Details
- NPI
- 1366416653
- Entity type
- Organization (NPI-2)
- Legal business name
- Memphis Dermatology Clinic PA
- Organization subpart
- No
- Enumeration date
- Feb 14, 2006
- Certification date
- Apr 15, 2024
- Last updated
- Apr 15, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | – | – | Yes |
Other names
- Professional Association (Other Name)
Practice location
1455 Union AveMemphis, TN 38104-6727
Phone 901-726-6655 · Fax 901-726-9056
Mailing address
1455 Union AveMemphis, TN 38104-6727
Phone 901-726-6655 · Fax 901-726-9056
Authorized official
Lynn Harris
Administrative Assistant
9017266655
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