Organization
CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CONNER MD (OWNER)
(901) 270-9145
Entity
Organization
Contact information
Practice address
3393 KIRBY RD, MEMPHIS, TN 38115-4253
(901) 542-0864
Mailing address
1011 W POPLAR AVE STE 5, COLLIERVILLE, TN 38017-2577
(901) 607-9064
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
06/27/2018
Last updated
04/25/2019
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