| Perry C. Rothrock Iii, M.d. Pllc | |
|
8309 Cordova Rd Cordova TN 38016-2046 | |
| (901) 757-9984 | |
| (901) 757-0536 |
| Full Name | Perry C. Rothrock Iii, M.d. Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 8309 Cordova Rd, Cordova, Tennessee |
| Authorized Official Name and Position | Perry Clyde Rothrock (OWNER) |
| Authorized Official Contact | 9017579984 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Perry C. Rothrock Iii, M.d. Pllc 8309 Cordova Rd Cordova TN 38016-2046 Ph: (901) 757-9984 | Perry C. Rothrock Iii, M.d. Pllc 8309 Cordova Rd Cordova TN 38016-2046 Ph: (901) 757-9984 |
| NPI Number | 1619138377 |
|---|---|
| Provider Enumeration Date | 06/24/2008 |
| Last Update Date | 05/07/2015 |
| Medicare PECOS PAC ID | 5092757906 |
|---|---|
| Medicare Enrollment ID | O20080707000373 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619138377 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 37500 (Tennessee) | Primary |
| Provider Name | Perry C Rothrock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023093655 PECOS PAC ID: 4082697651 Enrollment ID: I20040612000685 |
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