Individual
LATTIMORE MADISON MICHAEL II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6325 HUMPHREYS BLVD, MEMPHIS, TN 38120-2300
(901) 522-7700
(901) 259-2022
Mailing address
6325 HUMPHREYS BLVD, MEMPHIS, TN 38120-2300
(901) 522-7700
(901) 522-2600
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
19724
MS
207T00000X
Neurological Surgery Physician
Primary
32108
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008470507
—
MS
05
—
3328581
—
TN
Enumeration date
11/02/2005
Last updated
04/04/2024
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