Organization
MID-SOUTH INFECTIOUS DISEASE ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANOJ K JAIN MD (PRESIDENT)
(901) 681-0778
Entity
Organization
Contact information
Practice address
6029 WALNUT GROVE RD STE 209, MEMPHIS, TN 38120-2112
(901) 681-0778
(901) 821-9987
Mailing address
6029 WALNUT GROVE RD STE 209, MEMPHIS, TN 38120-2112
(901) 681-0778
(901) 821-9987
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD0000026445
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009015743
—
MS
05
—
3723463
—
TN
Enumeration date
06/25/2006
Last updated
01/24/2023
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