Provider Demographics
NPI:1497701700
Name:CARDIOLOGY SPECIALISTS OF MEMPHIS
Entity Type:Organization
Organization Name:CARDIOLOGY SPECIALISTS OF MEMPHIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER-PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-747-3330
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:DEPT 396
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148
Mailing Address - Country:US
Mailing Address - Phone:901-747-3330
Mailing Address - Fax:901-747-3245
Practice Address - Street 1:80 HUMPHREYS CENTER
Practice Address - Street 2:SUITE 202
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120
Practice Address - Country:US
Practice Address - Phone:901-747-3330
Practice Address - Fax:901-747-3245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
141165OtherBLUE CROSS
3716589Medicare ID - Type Unspecified