Organization
MID SOUTH REGIONAL THORACIC CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATHEW NINAN (OWNER)
(901) 259-4130
Entity
Organization
Contact information
Practice address
6029 WALNUT GROVE RD, SUITE 100, MEMPHIS, TN 38120-2112
(901) 259-4130
(901) 259-4131
Mailing address
6029 WALNUT GROVE RD, SUITE 100, MEMPHIS, TN 38120-2112
(901) 259-4130
(901) 259-4131
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD5950415
TN
Other
Enumeration date
03/03/2010
Last updated
03/03/2010
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