| Lifedoc Health | |
|
6063 Mount Moriah Road Ext Ste 4 Memphis TN 38115-2665 | |
| (901) 531-8800 | |
| (901) 531-8801 |
| Full Name | Lifedoc Health |
|---|---|
| Speciality | General Practice |
| Location | 6063 Mount Moriah Road Ext Ste 4, Memphis, Tennessee |
| Authorized Official Name and Position | Andrea Lajuana Ivory Fuller (BILLING AND CREDENTIALING MANAGER) |
| Authorized Official Contact | 9019225951 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifedoc Health 6625 Lenox Park Dr Ste 202 Memphis TN 38115-8200 Ph: (901) 922-5951 | Lifedoc Health 6063 Mount Moriah Road Ext Ste 4 Memphis TN 38115-2665 Ph: (901) 531-8800 |
| NPI Number | 1174184709 |
|---|---|
| Provider Enumeration Date | 06/25/2019 |
| Last Update Date | 06/12/2024 |
| Medicare PECOS PAC ID | 1759706567 |
|---|---|
| Medicare Enrollment ID | O20200810002957 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174184709 | NPI | - | NPPES |
| Q051384 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Pedro A Velasquez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003874801 PECOS PAC ID: 0143296467 Enrollment ID: I20040908001050 |
| Provider Name | Claudia P Neira |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598866568 PECOS PAC ID: 4486748662 Enrollment ID: I20070919000244 |
| Provider Name | Kelly Hoy |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1437177318 PECOS PAC ID: 5092980466 Enrollment ID: I20111213000796 |
| Provider Name | Aftab A Shaikh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1528018868 PECOS PAC ID: 2365479615 Enrollment ID: I20120731000541 |
| Provider Name | Lydia M Franklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083673792 PECOS PAC ID: 9537131958 Enrollment ID: I20131014000894 |
| Provider Name | Sentorita Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295117091 PECOS PAC ID: 7517276884 Enrollment ID: I20151028000343 |
| Provider Name | Morgin N Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477037786 PECOS PAC ID: 1850631193 Enrollment ID: I20190322001030 |
| Provider Name | Emily Marie Baldwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356810246 PECOS PAC ID: 8921424789 Enrollment ID: I20200811003841 |
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