Organization
SHELBY COUNTY PHYSICIANS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA ROSE HALE (DIRECTOR OF CREDENTIALING)
(770) 874-5439
Entity
Organization
Contact information
Practice address
6500 KIRBY GATE BLVD, MEMPHIS, TN 38119-2673
(901) 752-0772
Mailing address
5665 NEW NORTHSIDE DR STE 320, ATLANTA, GA 30328-5834
(770) 874-5400
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Enumeration date
03/04/2019
Last updated
03/04/2019
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