Individual
DR. FAZAL YAHYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4739
(662) 772-2980
(662) 772-2960
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24049
MS
207R00000X
Internal Medicine Physician
53158
TN
207R00000X
Internal Medicine Physician
E-13350
AR
Other
Enumeration date
04/16/2012
Last updated
08/18/2020
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