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NPI Code Detail

MEDICARE: MEMPHIS PSYCHIATRIC AND ADDICTION CLINIC, PC

MEDICARE: MEMPHIS PSYCHIATRIC AND ADDICTION CLINIC, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist

General Provider Information

NPI Number : 1285762880
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEMPHIS PSYCHIATRIC AND ADDICTION CLINIC, PC
Provider Business Mailing Address
First Line : 3150 LENOX PARK BLVD
Second Line : SUITE 214
City : MEMPHIS
State : TN
Zip : 38115-4299
Country : US
Telephone Number : 901-273-2368
Fax Number : 901-273-2351
Provider Business Practice Location Address
First Line : 3150 LENOX PARK BLVD
Second Line : SUITE 214
City : MEMPHIS
State : TN
Zip : 38115-4299
Country : US
Telephone Number : 901-273-2368
Fax Number : 901-273-2351
Authorized Official
Title or Position : OWNER
Name : DR. RADWAN R KHURI
Credential : MD
Telephone Number : 901-273-2368
Provider Enumeration Date : 03/02/2007
Last Update Date : 08/27/2007

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Directions to “MEMPHIS PSYCHIATRIC AND ADDICTION CLINIC, PC ” Practice Location

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