Organization
PATHOLOGY GROUP OF THE MIDSOUTH PC
Active
Other names
PGM Pathology Group of the Midsouth
Organization subpart
No
Provider details
NPI number
Authorized official
NORMAN O HILL (EXECUTIVE DIRECTOR)
(901) 542-6801
Entity
Organization
Contact information
Practice address
7550 WOLF RIVER BLVD, SUITE 200, GERMANTOWN, TN 38138-1780
(901) 542-6801
(901) 542-6871
Mailing address
7550 WOLF RIVER BLVD, SUITE 200, GERMANTOWN, TN 38138-1780
(901) 542-6801
(901) 542-6871
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
NA
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113467002
—
AR
05
—
3389000
—
TN
01
—
73934
BLUE CARE
TN
01
—
9014734
MEDICAID
MS
01
—
95562
BLUE CROSS
AR
01
—
CM0017
RAIL ROAD MEDICARE
—
Enumeration date
07/03/2006
Last updated
10/07/2014
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