# PERRY C. ROTHROCK III, M.D. PLLC

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

## Provider details

- **NPI number:** 1619138377
- **Authorized official:** PERRY CLYDE ROTHROCK III M.D. (OWNER)
- **Authorized official phone:** (901) 757-9984

## Contact information

- **Practice address:** 8309 CORDOVA RD, CORDOVA, TN 38016-2046
- **Practice address phone:** (901) 757-9984
- **Practice address fax:** (901) 757-0536
- **Mailing address:** 8309 CORDOVA RD, CORDOVA, TN 38016-2046
- **Mailing address phone:** (901) 757-9984
- **Mailing address fax:** (901) 757-0536

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 37500 | TN | Yes |

## Other

- **Enumeration date:** 06/24/2008
- **Last updated:** 05/07/2015