Provider Demographics
NPI:1578684007
Name:FURR, PHILIP MARVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:MARVIN
Last Name:FURR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 PERKINS EXT
Mailing Address - Street 2:STE 430
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-4410
Mailing Address - Country:US
Mailing Address - Phone:901-522-1700
Mailing Address - Fax:901-522-1747
Practice Address - Street 1:555 PERKINS EXT
Practice Address - Street 2:STE 430
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-4410
Practice Address - Country:US
Practice Address - Phone:901-522-1700
Practice Address - Fax:901-522-1747
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS09113207W00000X
TN15512207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN43532Medicaid
TN43532Medicaid
TNA97292Medicare UPIN