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Contact Information

MEMPHIS PEDIATRIC HEART
80 HUMPHREYS CENTER
SUITE 230
MEMPHIS, TN38120
 Phone: 901-259-2440
 Fax: 901-259-2444
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Cardiology

2080P0202X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for MEMPHIS PEDIATRIC HEART · (Female)

NPI # 1295080190
Status Active
Credentials
Entity Individual
Enumeration date 07/17/2012
Last updated 01/09/2019 - About 7 years ago
Sole proprietor 1 Not specified
Identifiers
  • TN License # 38471
  • TN Medicaid 1529767
  • TN Other 103G374694 MEDICARE GROUP PTAN NUMBER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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