Organization
ENT MEMPHIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDE HARRIS LAZAR M.D. (OWNER)
(901) 821-4317
Entity
Organization
Contact information
Practice address
791 ESTATE PL, MEMPHIS, TN 38120-0600
(901) 821-4300
(901) 821-4373
Mailing address
791 ESTATE PL, MEMPHIS, TN 38120-0600
(901) 821-4300
(901) 821-4373
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
016275
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3014587
—
TN
Enumeration date
10/17/2011
Last updated
10/17/2011
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