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NPI Code Detail

MEDICARE: CONRAD PEARSON CLINIC PC

MEDICARE: CONRAD PEARSON 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
1208800000XUrology Physician
2261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1992758882
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONRAD PEARSON CLINIC PC
Provider Business Mailing Address
First Line : 1325 WOLF PARK DR STE 103
Second Line :
City : GERMANTOWN
State : TN
Zip : 38138-1759
Country : US
Telephone Number : 901-252-3411
Fax Number : 901-384-6422
Provider Business Practice Location Address
First Line : 1325 WOLF PARK DR STE 102
Second Line :
City : GERMANTOWN
State : TN
Zip : 38138-1759
Country : US
Telephone Number : 901-252-3400
Fax Number : 901-682-0047
Authorized Official
Title or Position : PRESIDENT
Name : MICHAEL ANDREW GRANIERI
Credential : MD
Telephone Number : 901-252-3400
Provider Enumeration Date : 05/19/2006
Last Update Date : 11/26/2025

Similar Medicare Providers

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Practice Location Address:
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Practice Fax: 901-763-4305
1801811237 — VAL Y VOGT MD
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1306959861 — DR. PATRICK J ZIELIE M.D.
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38138-1759
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Practice Fax: 901-763-4305
1669676060 — VIBHA JAIN MD
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GERMANTOWN, TN
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1659544385 — DR. ADAM FREDERICK STEWART M.D.
Practice Location Address:
1325 WOLF PARK DR , SUITE 102
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1992095541 — MICHAEL GRANIERI M.D.
Practice Location Address:
1325 WOLF PARK DR STE 102
GERMANTOWN, TN
38138-1759
Practice Phone: 901-252-3400
Practice Fax: 901-763-4305

Directions to “CONRAD PEARSON CLINIC PC ” Practice Location

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