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Individual

COURTNEY BROOKE SHIRES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
7945 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1762
(901) 683-0055
(901) 685-2969
Mailing address
7714 POPLAR AVE STE 200, GERMANTOWN, TN 38138-3941
(901) 683-0055
(901) 685-2969

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
29339
MS
207Y00000X
Otolaryngology Physician
Primary
48308
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04088114
MS
05
1529232
TN
05
193392001
AR
Enumeration date
06/25/2007
Last updated
09/14/2021
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