Provider Demographics
NPI:1952402885
Name:MEDICOS GENERAL PLLC
Entity Type:Organization
Organization Name:MEDICOS GENERAL PLLC
Other - Org Name:MEDICOS PARA LA FAMILIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MACMILLAN
Authorized Official - Last Name:RODNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-383-8889
Mailing Address - Street 1:3030 COVINGTON PIKE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-5048
Mailing Address - Country:US
Mailing Address - Phone:901-383-8889
Mailing Address - Fax:901-383-2245
Practice Address - Street 1:3030 COVINGTON PIKE
Practice Address - Street 2:#100
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-5048
Practice Address - Country:US
Practice Address - Phone:901-383-8889
Practice Address - Fax:901-383-2245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3728192Medicaid
TN3728192Medicare PIN