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Organization
SLEEP DIAGNOSTICS, LLC
Active
Organization
SLEEP DIAGNOSTICS, LLC
Active
Other names
The Reggie White Sleep Disorder Center - Desoto
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEREK EVIN DENMAN SR. (CEO/PRESIDENT)
(901) 246-0767
Entity
Organization
Contact information
Practice address
7600 AIRWAYS BLVD, STE G, SOUTHAVEN, MS 38671
(662) 349-9802
(669) 349-9810
Mailing address
7600 AIRWAYS BLVD, STE G, SOUTHAVEN, MS 38671
(662) 349-9802
(669) 349-9810
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
2068
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03003864
—
MS
Enumeration date
05/31/2006
Last updated
12/02/2009
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