Provider Demographics
NPI:1356318752
Name:PILLAI, REKHA (MD)
Entity Type:Individual
Prefix:
First Name:REKHA
Middle Name:
Last Name:PILLAI
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:PO BOX 1885
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38101-1885
Mailing Address - Country:US
Mailing Address - Phone:901-725-8920
Mailing Address - Fax:901-725-8934
Practice Address - Street 1:3950 NEW COVINGTON PIKE
Practice Address - Street 2:STE 270
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128
Practice Address - Country:US
Practice Address - Phone:901-387-2120
Practice Address - Fax:901-387-2127
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000139082084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3012024Medicaid
130020263OtherRAILROAD MEDICARE
AR137779001Medicaid
TN3012024Medicare ID - Type Unspecified
A97596Medicare UPIN
AR137779001Medicaid