| Mid-south Act | |
|
119 Patterson Hall Main Office Memphis TN 38152-3510 | |
| (901) 678-1489 | |
| (901) 678-3215 |
| Full Name | Mid-south Act |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 119 Patterson Hall, Memphis, Tennessee |
| Authorized Official Name and Position | Lavonnie Perry-claybon (DIRECTOR) |
| Authorized Official Contact | 9016781489 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-south Act 119 Patterson Hall Main Office Memphis TN 38152-3510 Ph: (901) 678-1489 | Mid-south Act 119 Patterson Hall Main Office Memphis TN 38152-3510 Ph: (901) 678-1489 |
| NPI Number | 1518143692 |
|---|---|
| Provider Enumeration Date | 01/18/2008 |
| Last Update Date | 01/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518143692 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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