Provider Demographics
NPI:1851342471
Name:JULIA K. PUTNAM
Entity Type:Organization
Organization Name:JULIA K. PUTNAM
Other - Org Name:LIFE OPTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:KNOX
Authorized Official - Last Name:PUTNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-268-4229
Mailing Address - Street 1:74 SANDERS DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:TN
Mailing Address - Zip Code:38011-6501
Mailing Address - Country:US
Mailing Address - Phone:901-268-4229
Mailing Address - Fax:901-476-5638
Practice Address - Street 1:256 S CAMILLA ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3335
Practice Address - Country:US
Practice Address - Phone:901-528-1284
Practice Address - Fax:901-528-1289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000177682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty