Individual
FREDERICK GREGORY WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1244 PRIMACY PKWY, MEMPHIS, TN 38119-0201
(901) 767-8662
(901) 767-8666
Mailing address
6077 PRIMACY PKWY STE 140, MEMPHIS, TN 38119-5742
(901) 725-8347
(901) 259-7637
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
36520
TN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
36520
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00002219069 05
UNITED HEALTHCARE
TN
05
—
07187860
—
MS
01
—
0995742
CIGNA
TN
01
—
36520
TN LICENSE
TN
05
—
3874732
—
TN
01
—
4179731
BCBS
TN
01
—
620819926
CIGNA
TN
01
—
7951429
AETNA
TN
01
—
P00624366
RAILROAD MEDICARE
TN
Enumeration date
02/22/2006
Last updated
04/28/2021
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