Provider Demographics
NPI:1033595731
Name:MEMPHIS PATHOLOGY GROUP PC
Entity Type:Organization
Organization Name:MEMPHIS PATHOLOGY GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:HILSENBECK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-516-7182
Mailing Address - Street 1:1211 UNION AVE
Mailing Address - Street 2:SUITE 875
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6638
Mailing Address - Country:US
Mailing Address - Phone:901-516-7182
Mailing Address - Fax:901-276-5474
Practice Address - Street 1:1211 UNION AVE
Practice Address - Street 2:SUITE 875
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-6638
Practice Address - Country:US
Practice Address - Phone:901-516-7182
Practice Address - Fax:901-276-5474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty