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Specialty details in registry · Memphis, TN

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At a glance

3476 Summer Ave, Memphis, TN 38122-3610

NPPES record updated Aug 22, 2013. Public records can lag behind changes at a practice.

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Practice location

3476 Summer Ave
Memphis, TN 38122-3610

Professional details: NPI, taxonomy & registry record

NPI1730513037

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 101YA0400X
Enumeration date: Aug 22, 2013
Record updated: Aug 22, 2013

More registry details

Provider type: Organization · Type 2
Other reported name: <UNAVAIL>

Reported taxonomies and licenses

Specialty details in registry

101YA0400X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

3476 Summer Ave
Memphis, TN 38122-3610

Phone: (901) 736-8165

Mailing address

6878 MIKAYLA LN

CORDOVA, TN 380187921

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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