| Grace Family Medicine Llc | |
|
2900 Kirby Rd Suite 14 Memphis TN 38119-8221 | |
| (901) 754-3200 | |
| Not Available |
| Full Name | Grace Family Medicine Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2900 Kirby Rd, Memphis, Tennessee |
| Authorized Official Name and Position | Denise M Hightower (OWNER) |
| Authorized Official Contact | 9017543200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Family Medicine Llc Po Box 750183 Memphis TN 38175-0183 Ph: (901) 754-3200 | Grace Family Medicine Llc 2900 Kirby Rd Suite 14 Memphis TN 38119-8221 Ph: (901) 754-3200 |
| NPI Number | 1972652782 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 08/15/2007 |
| Medicare PECOS PAC ID | 8820181043 |
|---|---|
| Medicare Enrollment ID | O20070905000030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972652782 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 32177 (Tennessee) | Primary |
| Provider Name | Denise M Hightower |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396799300 PECOS PAC ID: 8820195928 Enrollment ID: I20070524000594 |
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