Individual
PHILLIP R NORTHCROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.C.
Contact information
Practice address
3440 POPLAR AVE, SUITE 13, MEMPHIS, TN 38111-4653
(901) 523-7781
Mailing address
3445 POPLAR AVE, STE 13, MEMPHIS, TN 38111-4667
(901) 523-7781
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD017326
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3020931
—
TN
01
—
3061799
BCBST
TN
Enumeration date
03/01/2006
Last updated
06/17/2016
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