Individual
MARY ELAINE KILLIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
51 N DUNLAP ST, MEMPHIS, TN 38105-4625
(901) 287-7337
(901) 937-6691
Mailing address
850 POPLAR AVE, BLDG 2, MEMPHIS, TN 38105-4607
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
59126
TN
2088P0231X
Pediatric Urology Physician
Primary
59126
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05235086
—
MS
05
—
Q050619
—
TN
Enumeration date
04/06/2012
Last updated
01/28/2025
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