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Organization
MEDICAL CENTER ENDOSCOPY GROUP
Active
Organization
MEDICAL CENTER ENDOSCOPY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER A HOLDEN (CHIEF MANAGER OF THE LLC)
(615) 665-1283
Entity
Organization
Contact information
Practice address
80 HUMPHREYS CTR, #200, MEMPHIS, TN 38120-2353
(901) 578-2538
(901) 578-2572
Mailing address
80 HUMPHREYS CTR, #200, MEMPHIS, TN 38120-2353
(901) 578-2538
(901) 578-2572
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0000000046
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3006899
BLUE CROSS OF TENNESSEE
TN
05
—
3287680
—
TN
Enumeration date
07/07/2006
Last updated
09/28/2007
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