Organization
PHOENIX NEUROSURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DENISE RENEE PURIFOY (OFFICE MANAGER)
(901) 276-6453
Entity
Organization
Contact information
Practice address
5673 S REX RD, MEMPHIS, TN 38119-3821
(901) 276-6400
(901) 276-6440
Mailing address
5673 S REX RD, MEMPHIS, TN 38119-3821
(901) 276-6400
(901) 276-6440
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3075466
MEDICARE ID
TN
Enumeration date
07/25/2007
Last updated
07/25/2007
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