Individual
SAMUEL RAY SCHROERLUCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1244 PRIMACY PKWY, MEMPHIS, TN 38119-0201
(901) 767-8662
(901) 767-8666
Mailing address
6077 PRIMACY PKWY STE 140, MEMPHIS, TN 38119-5742
(901) 725-8347
(901) 259-7637
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
45727
TN
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
45727
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1521876
—
TN
01
—
4269099
BCBS TN
TN
01
—
620819926
AETNA
TN
01
—
620819926
CIGNA
TX
01
—
9993516
AETNA
TN
01
—
P00881379
RAILROAD MEDICARE
TN
Enumeration date
05/02/2007
Last updated
03/25/2021
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