Organization
MID SOUTH PAIN & ANESTHESIA CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP EDWARD GREEN M.D. (OWNER)
(901) 761-0800
Entity
Organization
Contact information
Practice address
3087 PROFESSIONAL PLZ, GERMANTOWN, TN 38138-7912
(901) 761-0800
(901) 761-7738
Mailing address
PO BOX 382067, GERMANTOWN, TN 38183-2067
(901) 821-0338
(901) 761-7738
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
017865
TN
Other
Enumeration date
03/10/2014
Last updated
02/29/2024
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