Organization
PEDIATRIC SURGICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAX R LANGHAM JR. MD (PRESIDENT)
(901) 287-6031
Entity
Organization
Contact information
Practice address
806 ESTATE PL, MEMPHIS, TN 38120-0600
(901) 287-6031
(901) 287-4434
Mailing address
777 WASHINGTON AVE, SUITE P230, MEMPHIS, TN 38105-4550
(901) 287-6031
(901) 287-4434
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3386956
—
TN
Enumeration date
02/06/2007
Last updated
08/22/2020
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