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UT LEBONHEUR PEDIATRIC SPECIALISTS, INC.

Physicians Pediatrics Pediatric Nephrology

Provider NPI: 1093024101

Organization Information:
Organization Name:  UT LEBONHEUR PEDIATRIC SPECIALISTS, INC.
Organization is not Subpart
Authorized Official:  SHANNON M TACKER  VP/EXECUTIVE DIRECTOR  901-287-4692

Practice Location:
848 ADAMS AVE.  MEMPHIS, TN 38103 US
Tel: 901-287-7337  Fax: --

Business Mailing Address:
850 POPLAR AVE. BLDG. 2 MEMPHIS, TN 38105 US
Tel: 901-287-4692  Fax: 901-287-6804

NPI Information:
NPI: 1093024101
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N2080P0210XPhysicians
Pediatrics
Pediatric Nephrology
N2080P0214XPhysicians
Pediatrics
N2084N0402XPhysicians
Psychiatry & Neurology
N2085P0229XPhysicians
Radiology
N2080P0202XPhysicians
Pediatrics
N2080P0203XPhysicians
Pediatrics
N2080P0205XPhysicians
Pediatrics
N2080P0206XPhysicians
Pediatrics
N2080P0208XPhysicians
Pediatrics
N207WX0110X
N207YP0228XPhysicians
Otolaryngology
N2080P0008XPhysicians
Pediatrics
N2080P0201XPhysicians
Pediatrics
Y208000000XPhysicians
Pediatrics
N207NP0225XPhysicians
Dermatology

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 208000000X

Type:

Classification:



Definition:



MEDICAL JOBS TN - Page 1

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