Organization
DERMATOLOGY EAST ,P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUELLA G CHURCHWELL M.D (OWNER)
(901) 753-2794
Entity
Organization
Contact information
Practice address
DERMATOLOGY EAST ,P.L.L.C. 1335 CORDOVA CV, GERMANTOWN, TN 38138
(901) 753-2794
(901) 753-8876
Mailing address
DERMATOLOGY EAST ,P.L.L.C. 1335 CORDOVA CV, GERMANTOWN, TN 38138
(901) 753-2794
(901) 753-8876
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
06/08/2007
Last updated
05/08/2024
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