| Memphis And Shelby County Health Dept. | |
|
1064 Breedlove St Memphis TN 38107-2805 | |
| (901) 515-5400 | |
| (901) 526-1208 |
| Full Name | Memphis And Shelby County Health Dept. |
|---|---|
| Speciality | Pediatrics |
| Location | 1064 Breedlove St, Memphis, Tennessee |
| Authorized Official Name and Position | Clayton Moore (CONTROLLER) |
| Authorized Official Contact | 9012720387 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Memphis And Shelby County Health Dept. 877 Jefferson Ave 5th Floor Adams Pavilion Memphis TN 38103-2807 Ph: (901) 272-0387 | Memphis And Shelby County Health Dept. 1064 Breedlove St Memphis TN 38107-2805 Ph: (901) 515-5400 |
| NPI Number | 1073514055 |
|---|---|
| Provider Enumeration Date | 08/02/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073514055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 36735 (Tennessee) | Primary |
| 207R00000X | Internal Medicine | 26170 (Tennessee) | Primary |
| 208000000X | Pediatrics | 20023 (Tennessee) | Primary |
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