# COLLIERVILLE FAMILY MEDICINE PC

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

## Provider details

- **NPI number:** 1669794574
- **Authorized official:** SOWMYA BRAHMADEVI M.D. (OWNER)
- **Authorized official phone:** (901) 457-7060

## Contact information

- **Practice address:** 1500 W POPLAR AVE, SUITE 310, COLLIERVILLE, TN 38017-0601
- **Practice address phone:** (901) 457-7060
- **Practice address fax:** (901) 457-7062
- **Mailing address:** 1500 W POPLAR AVE, SUITE 310, COLLIERVILLE, TN 38017-0601
- **Mailing address phone:** (901) 457-7060
- **Mailing address fax:** (901) 457-7062

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/18/2010
- **Last updated:** 11/26/2013