Provider Demographics
NPI:1144400813
Name:MEMPHIS HAND CENTER, INC
Entity Type:Organization
Organization Name:MEMPHIS HAND CENTER, INC
Other - Org Name:SOUTHERN HAND CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:MACON
Authorized Official - Last Name:DUKES
Authorized Official - Suffix:
Authorized Official - Credentials:OT,CHT
Authorized Official - Phone:662-578-2110
Mailing Address - Street 1:447 HIGHWAY 6 E
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38606-3001
Mailing Address - Country:US
Mailing Address - Phone:662-578-2110
Mailing Address - Fax:662-578-2108
Practice Address - Street 1:156 HIGHWAY 51 S
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:MS
Practice Address - Zip Code:38606-2552
Practice Address - Country:US
Practice Address - Phone:662-578-2110
Practice Address - Fax:662-578-2108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2015-01-21
Deactivation Date:2014-09-03
Deactivation Code:
Reactivation Date:2015-01-21
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty