Organization
MID SOUTH WELLNESS CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY RAY FLOYD MD (OWNER)
(901) 873-2555
Entity
Organization
Contact information
Practice address
7662 HIGHWAY 51NORTH, SUITE 2, MILLINGTON, TN 38053
(901) 873-2555
(901) 873-2561
Mailing address
7662 HIGHWAY 51NORTH, SUITE 2, MILLINGTON, TN 38053
(901) 873-2555
(901) 873-2561
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD0000028821
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3378384
—
TN
Enumeration date
01/10/2007
Last updated
12/06/2007
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