Organization
THE PLASTIC SURGERY GROUP OF MEMPHIS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC W GIBSON (CFO)
(901) 373-2459
Entity
Organization
Contact information
Practice address
80 HUMPHREYS CTR STE 100, MEMPHIS, TN 38120-2352
(901) 761-9030
(901) 761-9591
Mailing address
8110 N BROTHER BLVD STE 200, BARTLETT, TN 38133-2760
(901) 373-2459
(901) 373-4511
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB8809
RAILROAD MEDICARE
TN
Enumeration date
08/15/2006
Last updated
10/08/2021
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