Individual
SUSAN N ISHIKAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1400 S GERMANTOWN RD, GERMANTOWN, TN 38138-2205
(901) 759-3100
Mailing address
1400 S GERMANTOWN RD, GERMANTOWN, TN 38138-2205
(901) 759-3100
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
15818
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02700342
—
MS
05
—
165780001
—
AR
05
—
Q017898
—
TN
Enumeration date
09/27/2005
Last updated
05/01/2018
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