Organization
PEDIATRIC UROLOGY ASSOCIATES OF THE MID-SOUTH, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD R JERKINS M.D. (PEDIATRIC UROLOGIST)
(901) 751-0500
Entity
Organization
Contact information
Practice address
1920 KIRBY PKWY, SUITE 100, GERMANTOWN, TN 38138-3696
(901) 751-0500
(901) 751-0551
Mailing address
1920 KIRBY PKWY, SUITE 100, GERMANTOWN, TN 38138-3696
(901) 751-0500
(901) 751-0551
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
MD0000008476
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3378412
MEDICARE
TN
Enumeration date
03/11/2008
Last updated
04/25/2008
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