Organization
ENT AMBULATORY CARE CENTER OF MEMPHIS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDE H LAZAR M.D. (OWNER)
(901) 821-4317
Entity
Organization
Contact information
Practice address
791 ESTATE PL, MEMPHIS, TN 38120-0600
(901) 821-4317
(901) 821-4373
Mailing address
27087 GRATIOT AVE, 2ND FL, ROSEVILLE, MI 48066-2985
(586) 498-9440
(586) 498-9460
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/08/2011
Last updated
09/08/2011
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