Organization
PRIME MEDICAL GROUP, PC
Active
Organization
PRIME MEDICAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TASLIM A KHATTAK MD (PRESIDENT)
(901) 255-1140
Entity
Organization
Contact information
Practice address
6005 PARK AVE, SUITE 433B, MEMPHIS, TN 38119-5202
(901) 255-1140
Mailing address
6005 PARK AVE STE 433B, MEMPHIS, TN 38119-5211
(901) 255-1140
(901) 255-1143
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016225
—
MS
05
—
3724095
—
TN
Enumeration date
08/31/2006
Last updated
05/02/2019
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