Provider Demographics
NPI:1629085758
Name:OVERSTREET, HUGH T (MD)
Entity Type:Individual
Prefix:
First Name:HUGH
Middle Name:T
Last Name:OVERSTREET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5374 ESTATE OFFICE DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3650
Mailing Address - Country:US
Mailing Address - Phone:901-683-1999
Mailing Address - Fax:901-683-1166
Practice Address - Street 1:5374 ESTATE OFFICE DR
Practice Address - Street 2:SUITE 2
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3650
Practice Address - Country:US
Practice Address - Phone:901-683-1999
Practice Address - Fax:901-683-1166
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD016668207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN110013243OtherRAILROAD MEDICARE
TN3016475Medicare PIN
TN110013243OtherRAILROAD MEDICARE