Organization
MEMPHIS CHILDREN'S CLINIC,PLLC
Active
Parent organization
MEMPHIS CHILDREN'S CLINIC, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEMPHIS CHILDREN'S CLINIC, PLLC
Authorized official
MS. CONNIE PURIFOY (ASSIST. OPERATIONS MANAGER)
(901) 396-0390
Entity
Organization
Contact information
Practice address
9860 GOODMAN RD, OLIVE BRANCH, MS 38654-1722
(662) 890-0158
(662) 890-8615
Mailing address
1129 HALE RD, MEMPHIS, TN 38116-6373
(901) 396-0390
(901) 507-7561
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3382354
—
TN
Enumeration date
11/05/2007
Last updated
11/05/2007
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