Organization
CHILD & ADOLESCENT PSYCHIATRY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY D HESTON (SENIOR PARTNER)
(901) 752-1980
Entity
Organization
Contact information
Practice address
1135 CULLY RD, #100, CORDOVA, TN 38016
(901) 752-1980
(901) 309-8784
Mailing address
PO BOX 1000, DEPT 233, MEMPHIS, TN 38148-0233
(901) 752-1980
(901) 309-8784
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3730256
—
TN
Enumeration date
09/14/2006
Last updated
08/22/2020
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