| Midsouth Primary Care Pc | |
|
6019 Walnut Grove Rd Memphis TN 38120-2113 | |
| (901) 240-8294 | |
| (901) 751-7054 |
| Full Name | Midsouth Primary Care Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6019 Walnut Grove Rd, Memphis, Tennessee |
| Authorized Official Name and Position | Alka Kamo (OFFICE MANAGER) |
| Authorized Official Contact | 9012408294 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midsouth Primary Care Pc 84 Hawk Glade Cv Cordova TN 38018-7763 Ph: (901) 240-8294 | Midsouth Primary Care Pc 6019 Walnut Grove Rd Memphis TN 38120-2113 Ph: (901) 240-8294 |
| NPI Number | 1427067941 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 08/07/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427067941 | NPI | - | NPPES |
| 3826065 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | TN0000030512 (Tennessee) | Primary |
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