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Contact Information

MEMPHIS PEDIATRIC GASTROENTEROLOGY & HEPATOLOGY PC
806 ESTATE PL
MEMPHIS, TN38120-0600
 Phone: 901-287-4017
 Fax: 901-287-4013
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Gastroenterology

2080P0206X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for MEMPHIS PEDIATRIC GASTROENTEROLOGY & HEPATOLOGY PC

NPI Number 1750455945
LBN Legal business name MEMPHIS PEDIATRIC GASTROENTEROLOGY & HEPATOLOGY PC
Authorized official ROBIN REESE - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/20/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
MS Medicaid 09010528
TN Medicaid 3387689
AR Other 84107 ARK FIRST SOURCE
AR Other 84107 BLUE CROSS OF ARKANSAS
AR Other 84107 US ABLE ADMINISTRATOR
TN Other 3387689 AARP CLAIM UNIT
TN Other 0048573 BLUE CROSS GROUP ID
TN Other 3387689 HEALTHSOURCE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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