| Midtown Clinic Llc | |
|
1726 Poplar Ave Memphis TN 38104-6426 | |
| (901) 698-9958 | |
| (901) 698-9968 |
| Full Name | Midtown Clinic Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1726 Poplar Ave, Memphis, Tennessee |
| Authorized Official Name and Position | Sanjeev Kumar (OWNER/MD) |
| Authorized Official Contact | 9016989958 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midtown Clinic Llc 1726 Poplar Ave Memphis TN 38104-6426 Ph: (901) 698-9958 | Midtown Clinic Llc 1726 Poplar Ave Memphis TN 38104-6426 Ph: (901) 698-9958 |
| NPI Number | 1558043430 |
|---|---|
| Provider Enumeration Date | 08/01/2023 |
| Last Update Date | 11/10/2023 |
| Medicare PECOS PAC ID | 6406207398 |
|---|---|
| Medicare Enrollment ID | O20240104002351 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558043430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Sanjeev Kumar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932381530 PECOS PAC ID: 6103011655 Enrollment ID: I20131122001034 |
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