Provider Demographics
NPI:1952136301
Name:MID-SOUTH OB-GYN PLLC
Entity type:Organization
Organization Name:MID-SOUTH OB-GYN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER - PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:HINOTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-747-1200
Mailing Address - Street 1:6215 HUMPHREYS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2382
Mailing Address - Country:US
Mailing Address - Phone:901-747-1200
Mailing Address - Fax:901-747-1645
Practice Address - Street 1:6215 HUMPHREYS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2382
Practice Address - Country:US
Practice Address - Phone:901-747-1200
Practice Address - Fax:901-747-1645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-05
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty