Individual
SUSAN MOKHTARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1910 NONCONNAH BLVD, SUITE 120, MEMPHIS, TN 38132-2113
(901) 448-2300
(901) 448-6657
Mailing address
66 N PAULINE ST, SUITE 206, MEMPHIS, TN 38105-5105
(901) 448-1480
(901) 448-8015
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
27884
TN
207LA0401X
Addiction Medicine (Anesthesiology) Physician
Primary
18474
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3836655
—
TN
Enumeration date
09/25/2006
Last updated
07/15/2022
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