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Organization
PATHOLOGY GROUP OF THE MIDSOUTH PC
Active
Organization
PATHOLOGY GROUP OF THE MIDSOUTH PC
Active
Other names
PGM Pathology Group of the Midsouth
Organization subpart
No
Provider details
NPI number
Authorized official
NORMAN O HILL (EXECUTIVE DIRECTOR)
(901) 542-6801
Entity
Organization
Contact information
Practice address
7550 WOLF RIVER BLVD, SUITE 200, GERMANTOWN, TN 38138-1780
(901) 542-6801
(901) 542-6871
Mailing address
7550 WOLF RIVER BLVD, SUITE 200, GERMANTOWN, TN 38138-1780
(901) 542-6801
(901) 542-6871
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
NA
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113467002
—
AR
05
—
3389000
—
TN
01
—
73934
BLUE CARE
TN
01
—
9014734
MEDICAID
MS
01
—
95562
BLUE CROSS
AR
01
—
CM0017
RAIL ROAD MEDICARE
—
Enumeration date
07/03/2006
Last updated
10/07/2014
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