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5106 Tradeport Dr Memphis TN 38141-8235 | |
| (615) 000-0000 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 5106 Tradeport Dr, Memphis, Tennessee |
| Authorized Official Name and Position | Jonathan Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5500 Maryland Way Suite 400 Brentwood TN 37027-7048 Ph: () - | 5106 Tradeport Dr Memphis TN 38141-8235 Ph: (615) 000-0000 |
| NPI Number | 1275073801 |
|---|---|
| Provider Enumeration Date | 03/01/2017 |
| Last Update Date | 09/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275073801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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