Organization
DUCKWORTH PATHOLOGY GROUP REFERENCE LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS F O'BRIEN MD (PRESIDENT)
(901) 725-7551
Entity
Organization
Contact information
Practice address
1265 UNION AVE, 5TH FLOOR SHERROD WING, MEMPHIS, TN 38104-3415
(901) 725-7551
(901) 725-9721
Mailing address
1265 UNION AVE, 5TH FLOOR SHERROD WING, MEMPHIS, TN 38104-3415
(901) 725-7551
(901) 725-9721
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
3282
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44D0913215
CLIA
TN
Enumeration date
03/21/2012
Last updated
03/21/2012
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