Provider Demographics
NPI:1669434429
Name:ENDOCRINOLOGY ASSOCIATES OF MEMPHIS, PLLC
Entity type:Organization
Organization Name:ENDOCRINOLOGY ASSOCIATES OF MEMPHIS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:S
Authorized Official - Last Name:SACKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-681-0346
Mailing Address - Street 1:6027 WALNUT GROVE RD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2145
Mailing Address - Country:US
Mailing Address - Phone:901-681-0346
Mailing Address - Fax:901-682-7737
Practice Address - Street 1:6027 WALNUT GROVE RD
Practice Address - Street 2:SUITE 307
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2145
Practice Address - Country:US
Practice Address - Phone:901-681-0346
Practice Address - Fax:901-682-7737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3280283Medicaid
TNCC9995OtherRAILROAD MEDICARE
TN3280283Medicaid