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Organization

IMPACT MIDSOUTH INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARQUITA WILLIAMS NP (OWNER)
(901) 584-8165
Entity
Organization

Contact information

Practice address
4512 TROUT VALLEY DR, MEMPHIS, TN 38141-7724
(901) 584-8165
Mailing address
3169 PLAYERS CLUB PKWY, MEMPHIS, TN 38125-8835
(901) 584-8165

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Enumeration date
11/03/2025
Last updated
11/03/2025
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