# MEMPHIS & SHELBY COUNTY PEDIATRIC GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487797536
- **Authorized official:** KATHERINE CARTER (BILLING SUPERVISOR)
- **Authorized official phone:** (901) 396-8366

## Contact information

- **Practice address:** 6479 WINCHESTER RD, SUITE 118, MEMPHIS, TN 38115-4240
- **Practice address phone:** (901) 866-2133
- **Practice address fax:** (901) 866-2136
- **Mailing address:** 1444 E SHELBY DR, SUITE 317, MEMPHIS, TN 38116-7260
- **Mailing address phone:** (901) 396-8281

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | NULL | Yes |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/15/2007
- **Last updated:** 08/22/2020