Organization
YOUR ENT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHRYN LENDERMAN KING FNP (OWNER)
(901) 861-2526
Entity
Organization
Contact information
Practice address
2028 W POPLAR AVE, SUITE 112, COLLIERVILLE, TN 38017-0618
(901) 861-2526
(901) 861-2527
Mailing address
2028 W POPLAR AVE, SUITE 112, COLLIERVILLE, TN 38017-0618
(901) 861-2526
(901) 861-2527
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
15081
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01434865
—
MS
05
—
1519558
—
TN
05
—
1740591437
—
MO
05
—
183493758
—
AR
01
—
3196332
UNITED HEALTH CARE
TN
01
—
4270955
BLUE CROSS/BLUE SHIELD
TN
01
—
5073174
CIGNA
TN
01
—
P00873707
MEDICARE RAILROAD
TN
Enumeration date
11/07/2016
Last updated
11/29/2016
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