| Memphis Psychiatric And Addiction Clinic, Pc | |
|
8356 Silverwind Dr Memphis TN 38125-0767 | |
| (901) 273-2368 | |
| (901) 273-2351 |
| Full Name | Memphis Psychiatric And Addiction Clinic, Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 8356 Silverwind Dr, Memphis, Tennessee |
| Authorized Official Name and Position | Radwan R Khuri (OWNER/PRESIDENT) |
| Authorized Official Contact | 9012732368 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Memphis Psychiatric And Addiction Clinic, Pc 8356 Silverwind Dr Memphis TN 38125-0767 Ph: (901) 273-2368 | Memphis Psychiatric And Addiction Clinic, Pc 8356 Silverwind Dr Memphis TN 38125-0767 Ph: (901) 273-2368 |
| NPI Number | 1235187949 |
|---|---|
| Provider Enumeration Date | 05/04/2006 |
| Last Update Date | 07/08/2011 |
| Medicare PECOS PAC ID | 2365499688 |
|---|---|
| Medicare Enrollment ID | O20050407000887 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235187949 | NPI | - | NPPES |
| 3708136 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Primary |
| Provider Name | Laurie Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063693893 PECOS PAC ID: 9133200363 Enrollment ID: I20080114000713 |
| Provider Name | Radwan R Khuri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578530036 PECOS PAC ID: 8729989926 Enrollment ID: I20100421000461 |
| Provider Name | Allyson B Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407115579 PECOS PAC ID: 0143485219 Enrollment ID: I20120625000067 |
| Provider Name | Alexander Labrador |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528516788 PECOS PAC ID: 7810269834 Enrollment ID: I20190508003504 |
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