# PARK HIGHLAND MEDICAL CLINIC, PLLC

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

## Provider details

- **NPI number:** 1689855124
- **Authorized official:** DR. SUDHA PRASAD M.D. (PHYSICIAN)
- **Authorized official phone:** (901) 324-3984

## Contact information

- **Practice address:** 3836 PARK AVE, MEMPHIS, TN 38111-6633
- **Practice address phone:** (901) 324-3984
- **Mailing address:** PO BOX 17962, MEMPHIS, TN 38187-0962

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 11/26/2007
- **Last updated:** 02/19/2009