Provider Demographics
NPI:1235904731
Name:MCDONALD MURRMANN CENTER FOR SKIN AND LASER LLC
Entity Type:Organization
Organization Name:MCDONALD MURRMANN CENTER FOR SKIN AND LASER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OBAJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-322-7020
Mailing Address - Street 1:7205 WOLF RIVER BLVD STE 155
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1758
Mailing Address - Country:US
Mailing Address - Phone:901-322-7020
Mailing Address - Fax:901-752-2018
Practice Address - Street 1:7205 WOLF RIVER BLVD STE 155
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1758
Practice Address - Country:US
Practice Address - Phone:901-322-7020
Practice Address - Fax:901-752-2018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Multi-Specialty