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Organization

A1 FAMILY PHYSICIANS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANDREA L IVORY FULLER CPC (PRESIDENT)
(901) 673-3111
Entity
Organization

Contact information

Practice address
890 GARLAND ST, MEMPHIS, TN 38107-4429
(901) 673-3111
Mailing address
890 GARLAND ST, MEMPHIS, TN 38107-4429
(901) 643-3556

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
133V00000X
Registered Dietitian
171400000X
Health & Wellness Coach
207Q00000X
Family Medicine Physician
Primary
207RN0300X
Nephrology Physician
208000000X
Pediatrics Physician
363A00000X
Physician Assistant
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
11/12/2024
Last updated
01/16/2025
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