Individual
MICHAEL LEE STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6215 HUMPHREYS BLVD STE 200, MEMPHIS, TN 38120-2382
(901) 512-6086
(833) 450-5323
Mailing address
6215 HUMPHREYS BLVD STE 200, MEMPHIS, TN 38120-2382
(901) 512-6086
(833) 450-5323
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
28719
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3840616
—
TN
01
—
4347596
BCBS
TN
01
—
P00475770
RAILROAD MEDICARE
—
Enumeration date
06/23/2005
Last updated
04/18/2024
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