Individual
MANOJ K JAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
6029 WALNUT GROVE RD STE 209, MEMPHIS, TN 38120-2112
(901) 681-0778
(901) 821-9987
Mailing address
6027 WALNUT GROVE RD, SUITE 312, MEMPHIS, TN 38120-2145
(901) 681-0778
(901) 821-9987
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD0000026445
TN
207RI0200X
Infectious Disease Physician
Primary
MD0000026445
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000116301
—
MS
05
—
3090453
—
TN
Enumeration date
06/12/2006
Last updated
01/24/2023
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