| Lendermon Sports Medicine Plc | |
|
9950 Crooked Creek Drive Collierville TN 38017 | |
| (901) 850-5756 | |
| (901) 850-5911 |
| Full Name | Lendermon Sports Medicine Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 9950 Crooked Creek Drive, Collierville, Tennessee |
| Authorized Official Name and Position | Pam Alexander (CEO) |
| Authorized Official Contact | 9017565565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lendermon Sports Medicine Plc Po Box 770929 Memphis TN 38177 Ph: () - | Lendermon Sports Medicine Plc 9950 Crooked Creek Drive Collierville TN 38017 Ph: (901) 850-5756 |
| NPI Number | 1952624041 |
|---|---|
| Provider Enumeration Date | 03/04/2010 |
| Last Update Date | 06/16/2011 |
| Medicare PECOS PAC ID | 0648309625 |
|---|---|
| Medicare Enrollment ID | O20100601000463 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952624041 | NPI | - | NPPES |
| 4254478 | Other | TN | BCBS TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| Provider Name | Laura N Lendermon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053326876 PECOS PAC ID: 1658339189 Enrollment ID: I20100312000091 |
| Provider Name | Benjamin M Petty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518252105 PECOS PAC ID: 8628216694 Enrollment ID: I20151117001943 |
| Provider Name | John Gardner |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1427509785 PECOS PAC ID: 6305110271 Enrollment ID: I20170918000196 |
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