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Organization
MID SOUTH REGIONAL THORACIC CENTER, LLC
Active
Organization
MID SOUTH REGIONAL THORACIC CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATHEW NINAN (OWNER)
(901) 259-4130
Entity
Organization
Contact information
Practice address
6029 WALNUT GROVE RD, SUITE 100, MEMPHIS, TN 38120-2112
(901) 259-4130
(901) 259-4131
Mailing address
6029 WALNUT GROVE RD, SUITE 100, MEMPHIS, TN 38120-2112
(901) 259-4130
(901) 259-4131
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD5950415
TN
Other
Enumeration date
03/03/2010
Last updated
03/03/2010
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