Organization
MEMPHIS CHILDREN'S CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT M BERTIN (PRACTICE MANAGER)
(901) 396-0390
Entity
Organization
Contact information
Practice address
3155 KIRBY WHITTEN ROAD, BARTLETT, TN 38134-2823
(901) 379-0092
(901) 379-0795
Mailing address
1129 HALE RD, MEMPHIS, TN 38116-6373
(901) 396-0390
(901) 396-3728
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3382354
—
TN
Enumeration date
10/16/2006
Last updated
01/28/2008
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