Northcross Internal Medicine, Pllc | |
3445 Poplar Ave Memphis TN 38111-4667 | |
(901) 523-7781 | |
(901) 523-7799 |
Full Name | Northcross Internal Medicine, Pllc |
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Speciality | Clinic/Center |
Location | 3445 Poplar Ave, Memphis, Tennessee |
Authorized Official Name and Position | Phillip R Northcross (MEDICAL DIRECTOR) |
Authorized Official Contact | 9015237781 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Northcross Internal Medicine, Pllc 3445 Poplar Ave Memphis TN 38111-4667 Ph: (901) 523-7781 | Northcross Internal Medicine, Pllc 3445 Poplar Ave Memphis TN 38111-4667 Ph: (901) 523-7781 |
NPI Number | 1871068361 |
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Provider Enumeration Date | 10/10/2018 |
Last Update Date | 10/10/2018 |
Medicare PECOS PAC ID | 8921344433 |
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Medicare Enrollment ID | O20190103002767 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871068361 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Phillip R Northcross |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1831166677 PECOS PAC ID: 3577553379 Enrollment ID: I20040513001486 |
Provider Name | Lauren D Albertine |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124658380 PECOS PAC ID: 2860829959 Enrollment ID: I20200302002318 |
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