Organization
PEDIATRIC ANESTHESIOLOGISTS P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIKRAM PATEL JR. MD (PRESIDENT)
(901) 291-2427
Entity
Organization
Contact information
Practice address
50 N DUNLAP ST, MEMPHIS, TN 38103-2800
(901) 572-3060
Mailing address
PO BOX 342629, BARTLETT, TN 38184-2629
(901) 291-2400
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
N/A
TN
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3621907
—
TN
05
—
3700547
—
TN
Enumeration date
07/20/2005
Last updated
08/05/2022
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