Organization
PEDIATRIC NEUROLOGY
Active
Organization
PEDIATRIC NEUROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA MOSIEJ BROWN (OFFICE ADMINISTRATOR)
(901) 405-0275
Entity
Organization
Contact information
Practice address
7645 WOLF RIVER CIR, GERMANTOWN, TN 38138-1751
(901) 405-0275
Mailing address
7645 WOLF RIVER CIR, GERMANTOWN, TN 38138-1751
(901) 405-0275
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
—
—
2084N0600X
Clinical Neurophysiology Physician
—
—
2084P0005X
Neurodevelopmental Disabilities Physician
—
—
Other
Enumeration date
01/03/2007
Last updated
05/19/2008
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