Provider Demographics
NPI:1124552526
Name:PRICE, FAITH CREEKMORE (MD)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:CREEKMORE
Last Name:PRICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6215 HUMPHREYS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2382
Mailing Address - Country:US
Mailing Address - Phone:901-747-1200
Mailing Address - Fax:
Practice Address - Street 1:6215 HUMPHREYS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2382
Practice Address - Country:US
Practice Address - Phone:901-747-1200
Practice Address - Fax:901-747-1220
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN63734207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty